Kackielo, Hanna
Kackielo, Hanna is an sole proprietor health care provider with primary practice located at 1 Towne Park Plz , Norwich CT 06360-2247. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Kackielo, Hanna can be contacted via phone (860) 887-0010.Contact Information
Primary practice address
1 Towne Park Plz
Norwich CT 06360-2247
Phone: (860) 887-0010
Fax: (860) 887-0178
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 037461 | Connecticut |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 037461 | Connecticut |
Profile Details
| NPI number | 1598714701 |
|---|---|
| LBN Legal business name | Kackielo, Hanna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 8th, 2006 |
| Last updated | Jun 19th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598714701 | NPPES |
| Connecticut | MEDICAID | 001374610 |
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