Healthcare Provider Details

I. General information

NPI: 1245152586
Provider Name (Legal Business Name): CAROLINE JANE RICUPERO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 STRAITS TPKE STE 303
MIDDLEBURY CT
06762-1836
US

IV. Provider business mailing address

217 MASSAPEAG RD
UNCASVILLE CT
06382-1934
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-0400
  • Fax: 203-598-0852
Mailing address:
  • Phone: 860-367-3128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number006404
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: