MEDICARE: MARYELLEN LUGENE ALBINI CPM 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	176B00000X	Midwife	98040010
2	225100000X	Physical Therapist	004682	CT

General Provider Information

NPI Number	:	1669517884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYELLEN LUGENE ALBINI CPM PT

Provider Business Mailing Address
First Line	:	25 HOWARD STREET
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06513-4036
Country	:	US
Telephone Number	:	203-468-8026
Fax Number	:	203-468-8026

Provider Business Practice Location Address
First Line	:	25 HOWARD STREET
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06513-4036
Country	:	US
Telephone Number	:	203-468-8026
Fax Number	:	203-468-8026

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	09/11/2025

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