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NPI Code Detail

MEDICARE: JACQUELYN HOPE CARR

MEDICARE: JACQUELYN HOPE CARR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11645CT

General Provider Information

NPI Number : 1285298208
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN HOPE CARR
Provider Business Mailing Address
First Line : 9 STONY HILL CT
Second Line :
City : SUMMIT
State : NJ
Zip : 07901-3059
Country : US
Telephone Number : 601-927-0785
Fax Number :
Provider Business Practice Location Address
First Line : 100 REDDING RD
Second Line :
City : REDDING
State : CT
Zip : 06896-3236
Country : US
Telephone Number : 203-544-7733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2019
Last Update Date : 10/20/2020

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Directions to “ JACQUELYN HOPE CARR ” Practice Location

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