Healthcare Provider Details

I. General information

NPI: 1023707247
Provider Name (Legal Business Name): LINDSAY NOLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1353 GOLD STAR HWY
GROTON CT
06340-2739
US

IV. Provider business mailing address

117 BALDWIN ST
WEST HAVEN CT
06516-7205
US

V. Phone/Fax

Practice location:
  • Phone: 401-600-1683
  • Fax:
Mailing address:
  • Phone: 203-907-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5878
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: