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NPI Code Detail

MEDICARE: MS. CRYSTAL ANN GATCOMB OTR/L

MEDICARE: MS. CRYSTAL ANN GATCOMB OTR/L
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
1225X00000XOccupational Therapist003376CT

General Provider Information

NPI Number : 1285864199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRYSTAL ANN GATCOMB OTR/L
Provider Business Mailing Address
First Line : 22 SCHOOL ST
Second Line :
City : PLAINVILLE
State : CT
Zip : 06062-2326
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1715 ELLINGTON RD
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2707
Country : US
Telephone Number : 860-478-9260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2009
Last Update Date : 03/04/2026

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