=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386559466
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE CARD BELLEVILLE P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2026
-----------------------------------------------------
Last Update Date | 08/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 365 MONTAUK AVE
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06320-4769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-442-0711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36 ROUND HILL RD
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06420-3850
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-334-0304
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 003897
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------