Craig R Denegar, PT
Individual provider Active NPI Physical Therapist · Storrs Mansfield, CT
NPI 1023072345 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023072345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT007701L (PA)
- Practice address
- Physical Therapy
358 Mansfield Road, Unit 2101
Storrs Mansfield, CT 06269-2101 - Phone
- (860) 486-0052
- Fax
- (860) 486-1158
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT007701L | PA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT007701L | PA | Yes |
Addresses
Primary practice location
Physical Therapy
358 Mansfield Road, Unit 2101
Storrs Mansfield, CT 06269-2101
Mailing address
Physical Therapy
358 Mansfield Road, Unit 2101
Storrs, CT 06269-2101
Phone (860) 486-0052
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017957400001 | Medicaid | PA |
Other providers in Storrs Mansfield, CT
- Creative Therapeutics, LLC
- Scott Cross
- Zachary Cutler
- Carmel F Cuyler
- Steven J Dauer
- Laurie L Devaney
- Richard Paul Dibala
- Paula Dombek
- Eastern Highlands Health District
- Bruce Nicholas Elliott
All providers in Storrs Mansfield, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.