Provider Demographics
NPI:1932201308
Name:SZWEZ, PAUL ILARIO (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ILARIO
Last Name:SZWEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 PROSPECT AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2965
Mailing Address - Country:US
Mailing Address - Phone:860-742-0290
Mailing Address - Fax:
Practice Address - Street 1:557 PROSPECT AVE FL 3
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2965
Practice Address - Country:US
Practice Address - Phone:860-742-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000643111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4087278Medicaid
CT350000421Medicare ID - Type Unspecified
CT350000940Medicare ID - Type Unspecified
CT4087278Medicaid