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General NPI Number Information
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NPI Number | 1285431130
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Entity Type | Organization
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Legal Business Name | PREFERRED THERAPY OUTPATIENT SERVICES, LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 425 DROZDYK DR
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City | GROTON
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State | CT
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Zip | 06340-4248
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Country | US
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Telephone | 860-610-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 850 SILAS DEANE HWY FL 2
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City | WETHERSFIELD
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State | CT
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Zip | 06109-3440
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OUTPATIENT SERVICES
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Name | RACHAEL MAIOCCO PERCOCO
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Credential |
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Telephone | 860-918-4742
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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