Provider Demographics
NPI:1225015746
Name:RECZEK, DANUTA MALGORZATA (DPM)
Entity Type:Individual
Prefix:
First Name:DANUTA
Middle Name:MALGORZATA
Last Name:RECZEK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 HEMINGWAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-2384
Mailing Address - Country:US
Mailing Address - Phone:203-466-1410
Mailing Address - Fax:203-466-6410
Practice Address - Street 1:365 HEMINGWAY AVE
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-2384
Practice Address - Country:US
Practice Address - Phone:203-466-1410
Practice Address - Fax:203-466-6410
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT543213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3701174001OtherCIGNA ID #
CT6201078OtherGHI PROVIDER ID #
CTNHS419OtherOXFORD HEALTH PLAN ID #
CT0V0033OtherHEALTH NET PROVIDER ID #
CT4224640OtherAETNA PROVIDER #
CT030000543CT01OtherBCBS PROVIDER #
CTU21641Medicare UPIN