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General NPI Number Information
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NPI Number | 1295358679
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Entity Type | Individual
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Provider Name | ATHENA PETROPOULOS FOREIT
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 761 MAIN AVE STE 112S
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City | NORWALK
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State | CT
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Zip | 06851-1080
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Country | US
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Telephone | 203-857-4741
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Fax |
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Provider Business Mailing Address
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Address Line | 136 PARTRICK AVE
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City | NORWALK
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State | CT
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Zip | 06851-2623
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Country | US
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Telephone | 203-984-2125
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 286
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License Number State | CT
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