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General NPI Number Information
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NPI Number | 1487540894
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Entity Type | Individual
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Provider Name | BRIANA ROSE AVITABLE
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Gender | Female
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 8 S COMMONS RD
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City | WATERBURY
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State | CT
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Zip | 06704-1035
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Country | US
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Telephone | 203-759-1229
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SUMMER PL
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City | MERIDEN
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State | CT
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Zip | 06451-5486
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Country | US
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Telephone | 203-868-9861
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15186
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License Number State | CT
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