Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 59263 | MA |
NPI | 1194711374 |
---|---|
Provider Name | Dr. Halina Wiczyk |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 20/05/2016 |