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NPI Code Detail

MEDICARE: MAUREEN ANN MELLEKY RPT

MEDICARE: MAUREEN ANN MELLEKY RPT
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 Therapist003604CT

General Provider Information

NPI Number : 1144216623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN ANN MELLEKY RPT
Provider Business Mailing Address
First Line : 101 N PLAINS INDUSTRIAL RD
Second Line : STE 100
City : WALLINGFORD
State : CT
Zip : 06492-2360
Country : US
Telephone Number : 203-265-0018
Fax Number : 203-265-4368
Provider Business Practice Location Address
First Line : 101 N PLAINS INDUSTRIAL RD
Second Line : STE 100
City : WALLINGFORD
State : CT
Zip : 06492-2360
Country : US
Telephone Number : 203-265-0018
Fax Number : 203-265-4368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 07/08/2007

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Directions to “ MAUREEN ANN MELLEKY RPT” Practice Location

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