Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand |
NPI | 1255984415 |
---|---|
Provider Name | Ariel K Cerruto |
First Address | Torrington, CT 06790-3493 |
Second Address | Torrington, CT 06790-3493 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2019 |
Last Update Date | 17/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1699874404 | NPI FOR GROUP (01) | CT |