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NPI Code Detail

MEDICARE: SUSAN ESPER DENEGAR PHYSICAL THERAPIST

MEDICARE:   SUSAN ESPER DENEGAR  PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist8328CT

General Provider Information

NPI Number : 1073220265
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ESPER DENEGAR PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 152 WORMWOOD HILL RD
Second Line :
City : MANSFIELD CENTER
State : CT
Zip : 06250-1145
Country : US
Telephone Number : 860-823-7727
Fax Number :
Provider Business Practice Location Address
First Line : 14 CLUB RD
Second Line :
City : WINDHAM
State : CT
Zip : 06280-1000
Country : US
Telephone Number : 860-456-1107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2022
Last Update Date : 10/28/2022

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Directions to “ SUSAN ESPER DENEGAR PHYSICAL THERAPIST” Practice Location

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