Provider Demographics
NPI:1811162076
Name:PACHOLSKI, MICHAEL T (APRN, CRNA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:T
Last Name:PACHOLSKI
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Gender:M
Credentials:APRN, CRNA
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5266
Practice Address - Fax:860-563-0741
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2015-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CTCP43081367500000X
CT3784367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered