Provider Demographics
NPI:1326050311
Name:WISNIEWSKI-ZYSKOWSKI, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WISNIEWSKI-ZYSKOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LONG LOTS RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3828
Mailing Address - Country:US
Mailing Address - Phone:203-227-1251
Mailing Address - Fax:203-226-8616
Practice Address - Street 1:30 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3628
Practice Address - Country:US
Practice Address - Phone:203-276-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0396012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT779334000OtherAETNA / MAGELLAN
CTP3402606OtherOXFORD HEALTH PLAN
CTTINOtherUNITED BEHAVIORAL HEALTH
CT347935OtherHEALTH NET
CTP00292934OtherRAILROAD MEDICARE
CT010039601CT01OtherANTHEM BEHAVORIAL HEALTH