Healthcare Provider Details

I. General information

NPI: 1871971036
Provider Name (Legal Business Name): ANTONIO ZARLENGO OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 MAIN ST
EAST HARTFORD CT
06108-3115
US

IV. Provider business mailing address

745 MAIN ST
EAST HARTFORD CT
06108-3115
US

V. Phone/Fax

Practice location:
  • Phone: 867-289-2791
  • Fax:
Mailing address:
  • Phone: 860-289-2791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number002522
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: