Scott Fidrych
Individual provider Active NPI Physical Rehabilitation Occupational Therapist · Colchester, CT
NPI 1043665086 · NPPES record last updated Apr 27, 2016
Key facts
- NPI
- 1043665086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Rehabilitation Occupational Therapist 225XP0019X
- License
- 002764 (CT)
- Practice address
- 310 Shailor Hill Rd
Colchester, CT 06415-2509 - Phone
- (860) 367-4323
- NPI assigned
- Apr 27, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 002764 | CT | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 002764 | CT | Yes |
Addresses
Primary practice location
310 Shailor Hill Rd
Colchester, CT 06415-2509
Mailing address
310 Shailor Hill Rd
Colchester, CT 06415-2509
Other providers in Colchester, CT
- Eastern Connecticut Rehabilitation Centers
- Caitlyn Eaton
- Genevieve Elliott
- Elizabeth Feteris
- May Ragna Fianna
- Rondelle Mille Fischmann
- Janine Fonfara
- Mary-Margaret Ellen Freier
- Janice Fuller
- Lara Galazin
All providers in Colchester, CT · Physical Rehabilitation Occupational 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 Apr 27, 2016. 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.