Provider Demographics
NPI:1093852600
Name:MARKOWICZ, PIOTR TOMASZ (DC)
Entity Type:Individual
Prefix:DR
First Name:PIOTR
Middle Name:TOMASZ
Last Name:MARKOWICZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06018-2466
Mailing Address - Country:US
Mailing Address - Phone:860-824-0748
Mailing Address - Fax:860-824-0749
Practice Address - Street 1:35 CHURCH ST
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06018-2466
Practice Address - Country:US
Practice Address - Phone:860-824-0748
Practice Address - Fax:860-824-0749
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00620000111N00000X
CT171100000X
CT001819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJV08789Medicare UPIN
NJ099766Medicare ID - Type UnspecifiedMEDICARE