MEDICARE: JEFFREY F PISCIONIERE

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
1	225100000X	Physical Therapist	006261	CT

General Provider Information

NPI Number	:	1285444190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY F PISCIONIERE

Provider Business Mailing Address
First Line	:	18 ARROWHEAD LN
Second Line	:
City	:	SHELTON
State	:	CT
Zip	:	06484-2030
Country	:	US
Telephone Number	:	203-521-2649
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 ARROWHEAD LN
Second Line	:
City	:	SHELTON
State	:	CT
Zip	:	06484-2030
Country	:	US
Telephone Number	:	203-521-2649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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