Provider Demographics
NPI:1336292150
Name:WASKOWITZ, ROBERT S (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:WASKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:74 BATTERSON PARK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2565
Mailing Address - Country:US
Mailing Address - Phone:860-549-8276
Mailing Address - Fax:860-674-8084
Practice Address - Street 1:201 N MOUNTAIN RD STE 302
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1848
Practice Address - Country:US
Practice Address - Phone:860-224-6830
Practice Address - Fax:860-223-7915
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2021-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT038742207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP2122526OtherOXFORD
CT5719044OtherAETNA
CTP2122526OtherOXFORD