MEDICARE: MRS. LINDA MARIE HODGKINS MS OTR/L CLT

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	174400000X	Specialist	001887	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0011116	OTHER	CT	HEALTHNET
2	130001887CT01	OTHER	CT	ANTHEM BLUE CROSS BLUE
3	7452628	OTHER	CT	AETNA
4	11116	OTHER	CT	CIGNA

General Provider Information

NPI Number	:	1801862073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA MARIE HODGKINS MS OTR/L CLT

Provider Business Mailing Address
First Line	:	3074 WHITNEY AVE
Second Line	:	BUILDING 1
City	:	HAMDEN
State	:	CT
Zip	:	06518-2391
Country	:	US
Telephone Number	:	203-230-2800
Fax Number	:	203-230-9791

Provider Business Practice Location Address
First Line	:	3074 WHITNEY AVE
Second Line	:	BUILDING 1
City	:	HAMDEN
State	:	CT
Zip	:	06518-2391
Country	:	US
Telephone Number	:	203-230-2800
Fax Number	:	203-230-9791

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	11/01/2007

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