Healthcare Provider Details

I. General information

NPI: 1487411856
Provider Name (Legal Business Name): SAMANTHA CIPRIANI MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 03/04/2024
Certification Date: 03/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E HILL RD
SOUTHBURY CT
06488-1388
US

IV. Provider business mailing address

PO BOX 1172
WOODBURY CT
06798-1172
US

V. Phone/Fax

Practice location:
  • Phone: 203-262-6868
  • Fax:
Mailing address:
  • Phone: 203-994-6449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number002918
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: