Lidia Mikolaenko
Family Medicine in Waterbury, Connecticut
1497175228- Practice location
- 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418
- Phone
- 203-756-8021
- Fax
- —
- Last updated
- October 5, 2026
Lidia Mikolaenko is a Family Medicine based in Waterbury, CT. Lidia Mikolaenko practices in Waterbury, CT. The NPI Number for Lidia Mikolaenko is 1497175228 and holds a License No. 290112 (NY). The current practice location address for Lidia Mikolaenko is 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418 and can be reached out via phone at 203-756-8021.
Provider Profile Details
- NPI Number
- 1497175228
- Provider Name
- Lidia Mikolaenko
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418
- Phone Number
- 203-756-8021
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 19, 2014
- Last Update Date
- October 5, 2026
- Certification Date
- October 5, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 80 Phoenix Ave Ste 201
Waterbury, CT 06702-1418 - City
- Waterbury
- State
- Connecticut
- Zip
- 06702-1418
- Phone Number
- 203-756-8021
Provider Business Mailing Address Details
- Address
- 80 Phoenix Ave Ste 201
Waterbury, CT 06702-1418 - City
- Waterbury
- State
- CT
- Zip
- 06702-1418
- Phone Number
- 203-756-8021
License Information
- License Number (1)
- 290112
- License State (1)
- NY
- Taxonomy (1)
- Family Medicine · 207Q00000X
- License Number (2)
- 57241
- License State (2)
- CT
- Taxonomy (2)
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Lidia Mikolaenko?
The NPI number of Lidia Mikolaenko is 1497175228. It was assigned on April 19, 2014 and is currently active in the NPPES registry.
What is the specialty of Lidia Mikolaenko?
Lidia Mikolaenko is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NY under license number 290112.
Where does Lidia Mikolaenko practice?
The practice location is 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418. The office can be reached at 203-756-8021 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1497175228 directly on the NPPES registry website.