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Contact Information

MARK DZIEDZIC, MD
263 FARMINGTON AVE
FARMINGTON, CT06032-1956
 Phone: 860-679-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MARK DZIEDZIC · (Male)

NPI Number 1770775124
Status Active
Credentials MD
Entity Individual
Enumeration date 08/09/2007
Last updated 07/18/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 046089
Hospital affiliation(s)
  • HOSPITAL OF CENTRAL CONNECTICUT THE - (Acute Care)
    100 GRAND STREET
    NEW BRITAIN, CT 06050
  • JOHNSON MEMORIAL HOSPITAL - (Acute Care)
    201 CHESTNUT HILL RD
    STAFFORD SPRINGS, CT 06076
  • MIDSTATE MEDICAL CENTER - (Acute Care)
    435 LEWIS AVE
    MERIDEN, CT 06450
  • WINDHAM COMM MEMORIAL HOSPITAL & HATCH HOSP - (Acute Care)
    112 MANSFIELD AVE
    WILLIMANTIC, CT 06226
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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