Healthcare Provider Details

I. General information

NPI: 1114913316
Provider Name (Legal Business Name): CHRISTOPHER BELLIZZI ATC/LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MOHEGAN AVE
NEW LONDON CT
06320-8100
US

IV. Provider business mailing address

69 BRIGHTWOOD LN
WEST HARTFORD CT
06110-1605
US

V. Phone/Fax

Practice location:
  • Phone: 860-444-8414
  • Fax: 860-444-8413
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number000272
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: