Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4994 | CT |
NPI | 1104304575 |
---|---|
Provider Name | Joshua Kevin Mcauliffe |
First Address | Glastonbury, CT 06033-4353 |
Second Address | Glastonbury, CT 06033-4353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2018 |
Last Update Date | 30/07/2018 |