MEDICARE: MRS. SVETLANA GITELMAN PT

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	225100000X	Physical Therapist	006593	CT

General Provider Information

NPI Number	:	1184797318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SVETLANA GITELMAN PT

Provider Business Mailing Address
First Line	:	37 RICHMOND LN
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06117-1627
Country	:	US
Telephone Number	:	860-236-7986
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WELLS ST
Second Line	:	#1B
City	:	HARTFORD
State	:	CT
Zip	:	06103-2928
Country	:	US
Telephone Number	:	860-525-2672
Fax Number	:	860-727-0897

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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