Provider Demographics
NPI:1760579296
Name:SZAJDA, TERESA M (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:SZAJDA
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:PO BOX 8026
Mailing Address - Street 2:7 NORTH WASHINGTON STREET SUITE 109
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-8026
Mailing Address - Country:US
Mailing Address - Phone:860-747-8118
Mailing Address - Fax:860-747-1633
Practice Address - Street 1:7 NORTH WASHINGTON STREET
Practice Address - Street 2:SUITE 109
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-8026
Practice Address - Country:US
Practice Address - Phone:860-747-8118
Practice Address - Fax:860-747-1633
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029393208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0R1832OtherHEALTHNET
CT010029393CT01OtherANTHEM BCBS
CT773713OtherCONNECTICARE
CT45758OtherAETNA US HEALTHCARE
CTHAP050OtherOXFORD
CT45758OtherAETNA US HEALTHCARE