Healthcare Provider Details

I. General information

NPI: 1386655280
Provider Name (Legal Business Name): KRISTEN APRIL SESESKE OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN APRIL BARRY

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WESTWOOD AVENUE SUITE 300
WATERBURY CT
06708
US

IV. Provider business mailing address

21 ROSE CRICLE
MERIDEN CT
06450
US

V. Phone/Fax

Practice location:
  • Phone: 203-597-1609
  • Fax: 203-597-1581
Mailing address:
  • Phone: 203-440-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number002769
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: