Healthcare Provider Details
I. General information
NPI: 1649399213
Provider Name (Legal Business Name): ANNA MARIA MAROTTI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
698 WEST AVE
NORWALK CT
06850-3302
US
IV. Provider business mailing address
216 FAIRFIELD BEACH RD
FAIRFIELD CT
06824-6842
US
V. Phone/Fax
- Phone: 203-855-3564
- Fax: 203-852-3418
- Phone: 203-256-1828
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | 004708 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: