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NPI Code Detail

MEDICARE: MS. JILL M MALONEY PT

MEDICARE: MS. JILL M MALONEY 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
1225100000XPhysical Therapist003716CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1513491OTHERCTAETNA
206140156402OTHERCTUHC

General Provider Information

NPI Number : 1710928742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JILL M MALONEY PT
Provider Business Mailing Address
First Line : 22 EAGLE RD
Second Line :
City : DANBURY
State : CT
Zip : 06810-4129
Country : US
Telephone Number : 203-778-8326
Fax Number : 203-792-9170
Provider Business Practice Location Address
First Line : 22 EAGLE RD
Second Line :
City : DANBURY
State : CT
Zip : 06810-4129
Country : US
Telephone Number : 203-778-8326
Fax Number : 203-792-9170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/14/2009

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Directions to “ MS. JILL M MALONEY PT” Practice Location

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