Provider Demographics
NPI:1013908029
Name:SZYNKOWICZ, PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:SZYNKOWICZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PENDLETON DRIVE
Mailing Address - Street 2:PO BOX 56-
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-0056
Mailing Address - Country:US
Mailing Address - Phone:860-228-1441
Mailing Address - Fax:860-228-1441
Practice Address - Street 1:10 PENDLETON DRIVE
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:CT
Practice Address - Zip Code:06248-0056
Practice Address - Country:US
Practice Address - Phone:860-228-1441
Practice Address - Fax:860-228-1441
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT652111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000652CT01OtherANTHEM BLUE CROSS BLUE SH
CT391886617OtherTRIAD HEALTHCARE
CT489605OtherUS HEALTH CARE
CTOR1143OtherLANDMARK HEALTH CARE
CT507474OtherAETNA
CTTOS023OtherOXFORD
CT070491OtherUNITED HEALTH CARE ACN
CT004083656Medicaid
CT4404211OtherUNITED HEALTH CARE
CT742798OtherCONNECTICARE
CT742798OtherCONNECTICARE