Healthcare Provider Details

I. General information

NPI: 1508996984
Provider Name (Legal Business Name): PATRICIA DUNN CANN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 CAMPBELL AVE
WEST HAVEN CT
06516-4408
US

IV. Provider business mailing address

23 STANLEY DR
SEYMOUR CT
06483-2023
US

V. Phone/Fax

Practice location:
  • Phone: 203-888-0371
  • Fax:
Mailing address:
  • Phone: 203-888-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number001792
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: