Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beverly Waczek

Individual provider Medical Physician Assistant · NPI 1629094131

Beverly Waczek is a Physician Assistant in Waterbury, Connecticut. Qualified in 2003, 23 years ago. Practices with Liberation Programs Inc, an 11-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
23
Licensed in
CT
In the registry since
2006
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Practice location Address checks out

64 Robbins St
Waterbury, CT 06708-2613
Phone: (203) 573-6295
Fax: (203) 573-7613
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 001477 (CT)

Record details

NPI number1629094131
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 15, 2006
Last updated in NPPESJanuary 8, 2008
Mailing address64 Robbins St, Waterbury, CT 06721-1589

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Liberation Programs Inc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Waterbury