Healthcare Provider Details

I. General information

NPI: 1689641805
Provider Name (Legal Business Name): RHEUMATOLOGY & HAND REHABILITAION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 DIXWELL AVE 3RD FLOOR
HAMDEN CT
06518-3508
US

IV. Provider business mailing address

3018 DIXWELL AVE 3RD FLOOR
HAMDEN CT
06518-3508
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-0090
  • Fax: 203-407-0558
Mailing address:
  • Phone: 203-288-0090
  • Fax: 203-407-0558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARY-ANN FLYNN
Title or Position: ADMINISTRATOR
Credential:
Phone: 203-288-0090