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NPI Code Detail

MEDICARE: CANDIDA LIONETTI PTA

MEDICARE: CANDIDA LIONETTI PTA
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
1225200000XPhysical Therapy Assistant000326CT

General Provider Information

NPI Number : 1558411173
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDIDA LIONETTI PTA
Provider Business Mailing Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number :
Provider Business Practice Location Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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Directions to “ CANDIDA LIONETTI PTA” Practice Location

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