Healthcare Provider Details

I. General information

NPI: 1255243986
Provider Name (Legal Business Name): JEANINE SANTILLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 ORONOQUE LN STE 303
STRATFORD CT
06614-1379
US

IV. Provider business mailing address

999 ORONOQUE LN STE 303
STRATFORD CT
06614-1379
US

V. Phone/Fax

Practice location:
  • Phone: 203-979-9440
  • Fax: 866-232-5535
Mailing address:
  • Phone: 203-979-9440
  • Fax: 866-232-5535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number003645
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: