Healthcare Provider Details

I. General information

NPI: 1609783091
Provider Name (Legal Business Name): GEOFFREY JOSEPH TWOHILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 POGMORE DR
WALLINGFORD CT
06492-5262
US

IV. Provider business mailing address

7 POGMORE DR
WALLINGFORD CT
06492-5262
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-2174
  • Fax:
Mailing address:
  • Phone: 203-688-2174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1265
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: