Healthcare Provider Details

I. General information

NPI: 1700702867
Provider Name (Legal Business Name): AMY L ESCOBAR-PEREZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 RESEARCH PKWY APT 414
MERIDEN CT
06450-8349
US

IV. Provider business mailing address

275 RESEARCH PKWY APT 414
MERIDEN CT
06450-8349
US

V. Phone/Fax

Practice location:
  • Phone: 203-909-8724
  • Fax:
Mailing address:
  • Phone: 203-909-8724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6866
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: