Provider Demographics
NPI:1992896351
Name:CHILICKI, JOZEF P (MA)
Entity type:Individual
Prefix:MR
First Name:JOZEF
Middle Name:P
Last Name:CHILICKI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:80 ALISON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-1149
Mailing Address - Country:US
Mailing Address - Phone:860-282-7972
Mailing Address - Fax:860-667-6842
Practice Address - Street 1:555 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2631
Practice Address - Country:US
Practice Address - Phone:860-594-6354
Practice Address - Fax:860-667-6842
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)