Provider Demographics
NPI:1497729206
Name:PAWLAK, SYLVESTER S (APRN)
Entity Type:Individual
Prefix:
First Name:SYLVESTER
Middle Name:S
Last Name:PAWLAK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 VILLAGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06472-1629
Mailing Address - Country:US
Mailing Address - Phone:203-925-9600
Mailing Address - Fax:
Practice Address - Street 1:6 CORPORATE DR
Practice Address - Street 2:NP RESOURCES, LLC
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6270
Practice Address - Country:US
Practice Address - Phone:203-925-9600
Practice Address - Fax:203-926-0594
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily