MEDICARE: MEREDITH WHITING

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
1	225XG0600X	Gerontology Occupational Therapist	002956	CT

General Provider Information

NPI Number	:	1164988242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH WHITING

Provider Business Mailing Address
First Line	:	215 FOREST ST
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-4947
Country	:	US
Telephone Number	:	860-482-8554
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 FOREST ST
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-4947
Country	:	US
Telephone Number	:	860-482-8554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	02/14/2019

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Directions to “ MEREDITH WHITING ” Practice Location

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