Provider Demographics
NPI:1568086726
Name:SIAWOR, DORIS
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:
Last Name:SIAWOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4532
Mailing Address - Country:US
Mailing Address - Phone:866-888-7610
Mailing Address - Fax:
Practice Address - Street 1:615 WEST JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4531
Practice Address - Country:US
Practice Address - Phone:866-888-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTNA8435119376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide