Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 0347 | NH |
NPI | 1003961913 |
---|---|
Provider Name | Dorothy D. Daponte |
First Address | Stratford, CT 06614-3300 |
Second Address | Bridgeport, CT 06610-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |