Healthcare Provider Details

I. General information

NPI: 1114037074
Provider Name (Legal Business Name): RONALD OGRODOWICZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BEARD SAWMILL RD
SHELTON CT
06484-6150
US

IV. Provider business mailing address

520 LAUGHLIN RD W
STRATFORD CT
06614-4116
US

V. Phone/Fax

Practice location:
  • Phone: 203-929-7036
  • Fax:
Mailing address:
  • Phone: 203-377-8931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: