Provider Demographics
NPI:1093482531
Name:GODLEWSKA, MARTA (RN)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:GODLEWSKA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 HUNTS BROOK RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1000
Mailing Address - Country:US
Mailing Address - Phone:860-442-9454
Mailing Address - Fax:
Practice Address - Street 1:78 HUNTS BROOK RD
Practice Address - Street 2:
Practice Address - City:QUAKER HILL
Practice Address - State:CT
Practice Address - Zip Code:06375-1009
Practice Address - Country:US
Practice Address - Phone:860-442-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT168346163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool