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General NPI Number Information
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NPI Number | 1215590088
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Entity Type | Individual
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Provider Name | BRITTNEY NICOLE OBOIKOVITZ-TASTO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 37 OAK RIDGE DR
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City | AVON
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State | CT
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Zip | 06001-2213
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Country | US
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Telephone | 860-790-0116
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Fax |
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Provider Business Mailing Address
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Address Line | 229 WILBURS LN
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City | GUILFORD
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State | CT
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Zip | 06437-1018
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Country | US
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Telephone | 203-907-9870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5158
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License Number State | CT
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