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1376226613
BROOKLYN LARISA MICKOLYZCK
MIDDLETOWN, CT
NPI
1376226613
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CT 13616)
Enumeration Date
2023-08-11
Last Update Date
2024-09-25
Business Address
BROOKLYN LARISA MICKOLYZCK DNP, FNP-BC
11 S MAIN ST
MIDDLETOWN, CT 06457-3656
Phone number: 860-347-4555
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Mailing Address
BROOKLYN LARISA MICKOLYZCK DNP, FNP-BC
30 GEORGE ST
NORTH HAVEN, CT 06473-1855
Phone number: 203-641-3059
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