Healthcare Provider Details

I. General information

NPI: 1891621025
Provider Name (Legal Business Name): ALIYAH ABIGAIL APPLEBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 WATERVIEW AVE
BRIDGEPORT CT
06608-2554
US

IV. Provider business mailing address

117 PROSPECT ST
PLANTSVILLE CT
06479-1116
US

V. Phone/Fax

Practice location:
  • Phone: 203-275-2301
  • Fax:
Mailing address:
  • Phone: 631-922-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: