Healthcare Provider Details

I. General information

NPI: 1790481836
Provider Name (Legal Business Name): SETH NEWMAN MS, OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 HEBRON AVE
GLASTONBURY CT
06033-5028
US

IV. Provider business mailing address

73 NORTON ST APT 1
WATERBURY CT
06708-4760
US

V. Phone/Fax

Practice location:
  • Phone: 860-652-3444
  • Fax:
Mailing address:
  • Phone: 203-528-5997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6745
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: