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General NPI Number Information
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NPI Number | 1780339697
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Entity Type | Individual
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Provider Name | CURTIS MANGANELLO OTR
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Gender | Male
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 1000 EVERGREEN WAY
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-5571
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Country | US
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Telephone | 860-851-9328
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Fax | 847-730-2490
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Provider Business Mailing Address
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Address Line | 69 ARLENE ST
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City | TORRINGTON
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State | CT
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Zip | 06790-3832
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Country | US
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Telephone | 860-796-9311
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Fax | 847-386-5180
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2408
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License Number State | CT
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