DR. MICHAEL BLAISE PRZYDZIELSKI SR. (NPI# 1124249735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124249735 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL BLAISE PRZYDZIELSKI SR. |
| Credential | MD |
| Practice Address |
49 School St. Hcrs Hartford VT 05047-0709 |
| Mailing Address |
390 River St Hcrs Springfield VT 05156-2226 |
| Practice Telephone | 8022953031 |
| Mailing Telephone | 8028864500 |
| Mailing Fax Number | 8028864520 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2015-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
042.0012022 | VT | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0420012022 | VT | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
15847 | NH | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
15847 | NH | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
042.0012022 | VT | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
0420012022 | VT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 3088049 | 05 |
| Street Address |
49 SCHOOL ST. HCRS |
| City | HARTFORD |
| State | VT |
| Zip Code | 05047-0709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578583142 | Patricia A Daly | Psychiatry & Neurology | 49 School St., Hcrs, Hartford, VT 05047 | 2006-07-19 |
| 1043521297 | Elizabeth B. Kooperkamp | Counselor | 49 School St., Hcrs, Hartford, VT 05047-0709 | 2010-06-22 |
| 1457526816 | Lynn M. Mccormick | Psychiatry & Neurology | 49 School St., Hcrs, Hartford, VT 05047-0709 | 2008-04-28 |
| 1538333059 | Karin A. Reed | Psychiatry & Neurology | 49 School St., Hcrs, Hartford, VT 05047-0709 | 2008-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316407166 | Stephany M Churchill | Counselor | 49 School Street, Hartford, VT 05047 | 2019-03-20 |
| 1437614872 | Caitlin Rotkiewicz | Counselor | 49 School Street, Hartford, VT 05047 | 2019-02-08 |
| 1275011272 | Tori Meder | Counselor | 49 School Street, Hartford, VT 05047 | 2018-08-01 |
| 1417403247 | Christine Lowery | Counselor | 49 School Street, Hartford, VT 05047 | 2016-08-31 |
| 1215220926 | Nicole L Maresca | Counselor | 49 School Street, Hartford, VT 05047 | 2011-05-27 |
| 1649401845 | Mark G Young | Counselor | 49 School St, Hartford, VT 05047 | 2009-08-05 |
| 1770651952 | Kathleen M Allden | Psychiatry & Neurology | 49 School Street, Hartford, VT 05047 | 2006-12-04 |
| 1417025693 | Edmund P Piper | Counselor | 49 School Street, Hartford, VT 05047 | 2006-12-04 |
| 1841368008 | Maris O Noble | Psychologist | 49 School Street, Hartford, VT 05047 | 2006-12-04 |
| 1215002522 | Brad M Sewall | Counselor | 49 School Street, Hartford, VT 05047 | 2006-11-21 |
| Find all providers in zip 05047 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750795217 | Lovejit Kaur | Psychiatry & Neurology | 282 Washington St, Hartford, CT 06106-3322 | 2014-06-12 |
| 1972769776 | Ernest Jermin II | Psychiatry & Neurology | 500 Blue Hills Ave, Hartford, CT 06112-1500 | 2008-07-31 |
| 1841483138 | Francisco A Ripepi | Psychiatry & Neurology | 200 Retreat Ave, Hartford Hospital Child Psychiatry, Hartford, CT 06106 | 2007-08-21 |
| 1861683039 | Sudeshna Basu | Psychiatry & Neurology | 200 Retreat Avenue, Hartford Hospital Child Psychiatry, Hartford, CT 06106-3310 | 2007-08-05 |
| 1992903330 | Salma Malik | Psychiatry & Neurology | 200 Retreat Avenue, Hartford Hospital Child Psychiatry, Hartford, CT 06106-3309 | 2007-07-06 |
| 1821292392 | Ramesh K Hemnani | Psychiatry & Neurology | 80 Jefferson St, Hartford, CT 06106-5035 | 2007-06-11 |
| 1336351048 | Samya Hashem Hawley | Psychiatry & Neurology | 1680 Albany Ave, Hartford, CT 06105-1001 | 2007-05-04 |
| 1972721405 | Jeffrey Seth Landau | Psychiatry & Neurology | 682 Prospect Ave, Hartford, CT 06105-4238 | 2007-04-22 |
| 1538245766 | Bernard J Langenauer | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1260 | 2006-10-31 |
| 1457447187 | Robert A Sahl | Psychiatry & Neurology | 200 Retreat Avenue, Hartford Hospital Child Psychiatry, Hartford, CT 06106 | 2006-10-04 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.