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Contact Information

KATHERINE E PROVAZNIK, DO
1260 SILAS DEANE HWY STE 101
WETHERSFIELD, CT06109-4363
 Phone: 860-545-7550
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Behavioral Neurology & Neuropsychiatry

2084B0040X
Indicates primary specialty

NPI Profile & details for KATHERINE E PROVAZNIK · (Female)

NPI # 1376002311
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/19/2019
Last updated 02/04/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • CT License # 82532
  • WI License # 2974
Hospital affiliation(s) Not Available
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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