CHRISTOPHER GEORGE KACZEGOWICZ
NPI 1063233591
Nurse Practitioner - Psychiatric/Mental Health in Middletown, CT
Active since October 17, 2024
About Christopher George Kaczegowicz NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHRISTOPHER GEORGE KACZEGOWICZ (NPI 1063233591) is an individual psychiatric/mental health provider in Middletown, Connecticut, licensed in Connecticut (14966) and active in the NPI registry since October 2024.
NPPES Registry Identity
NPI1063233591
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameCHRISTOPHER GEORGE KACZEGOWICZ
Location Address1586 COUNTRY CLUB RDMiddletown, CT 06457-2343
Mailing Address1586 Country Club RdMiddletown, CT 06457-2343
Phone(203) 400-5390
Sole ProprietorYes
Enumeration DateOctober 17, 2024
Last NPPES UpdateJune 26, 2025
NPPES CertifiedJune 26, 2025
✔ NPI 1063233591 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CT · 14966
Also ListedRegistered NurseTaxonomy 163W00000X · License 181598 (CT)
1586 COUNTRY CLUB RD, Middletown, CT 06457
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063233591, enumerated as an "individual" on October 17, 2024.
The provider is located at 1586 COUNTRY CLUB RD MIDDLETOWN, CT 06457 and the phone number is (203) 400-5390.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
