Provider Demographics
NPI:1033542204
Name:SUDOWSKI MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:SUDOWSKI MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-442-3180
Mailing Address - Street 1:210 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-2819
Mailing Address - Country:US
Mailing Address - Phone:860-442-3180
Mailing Address - Fax:860-447-9444
Practice Address - Street 1:210 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-2819
Practice Address - Country:US
Practice Address - Phone:860-442-3180
Practice Address - Fax:860-447-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
No111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty