Healthcare Provider Details

I. General information

NPI: 1134925480
Provider Name (Legal Business Name): EMILIE CHICANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILIE MAGGIPINTO

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 MIX AVE
HAMDEN CT
06514-2102
US

IV. Provider business mailing address

22 GARRIGUS CT
WOLCOTT CT
06716-3104
US

V. Phone/Fax

Practice location:
  • Phone: 203-281-3500
  • Fax:
Mailing address:
  • Phone: 413-426-5809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6574
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: