Healthcare Provider Details

I. General information

NPI: 1790728426
Provider Name (Legal Business Name): MARY LISA DRANSFIELD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 ROUTE 37
NEW FAIRFIELD CT
06812
US

IV. Provider business mailing address

69 SAND PIT RD STE 300
DANBURY CT
06810-4004
US

V. Phone/Fax

Practice location:
  • Phone: 203-312-0211
  • Fax: 203-312-0201
Mailing address:
  • Phone: 203-748-5631
  • Fax: 203-207-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number003134
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: