Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 003965 | CT |
Y | 225XH1200X | Occupational Therapist - Hand | 003965 | CT |
NPI | 1275961690 |
---|---|
Provider Name | Patrycja Marta Pedzinska |
First Address | Woodbridge, CT 06525-2258 |
Second Address | Woodbridge, CT 06525-2258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2013 |
Last Update Date | 27/08/2015 |