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General NPI Number Information
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NPI Number | 1689116949
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Entity Type | Individual
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Provider Name | GENEVIEVE ANN GYULAVARY DPT
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Gender | Female
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Dates
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Enumeration Date | 11/17/2016
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 320 WESTERN BLVD STE 105
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City | GLASTONBURY
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State | CT
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Zip | 06033-1276
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Country | US
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Telephone | 860-657-5955
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Fax | 860-657-5953
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Provider Business Mailing Address
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Address Line | 1257 JOHN FITCH BLVD
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2441
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Country | US
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Telephone | 845-988-7806
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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 | 22744
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11563
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License Number State | CT
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