Provider Demographics
NPI:1326371261
Name:BIELAWSKI, MARK PAUL JR (APRN)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:PAUL
Last Name:BIELAWSKI
Suffix:JR
Gender:M
Credentials:APRN
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Mailing Address - Street 1:VETERANS ADMINISTRATION
Mailing Address - Street 2:555 WILLARD AVENUE
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2631
Mailing Address - Country:US
Mailing Address - Phone:866-808-7921
Mailing Address - Fax:860-667-6875
Practice Address - Street 1:VETERANS ADMINISTRATION
Practice Address - Street 2:555 WILLARD AVENUE
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111
Practice Address - Country:US
Practice Address - Phone:866-808-7921
Practice Address - Fax:860-667-6875
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2019-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT5536363LP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care