Jeni Grandelski, DPT

Individual provider Active NPI Physical Therapist · Plainfield, CT

NPI 1144600628 · NPPES record last updated Jun 1, 2015

Key facts

NPI
1144600628
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7354 (SC)
Practice address
16 Windsor Ave
Plainfield, CT 06374-1036
Phone
(860) 564-4081
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7354SCMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7354 SC Yes

Addresses

Primary practice location

16 Windsor Ave
Plainfield, CT 06374-1036

Mailing address

16 Windsor Ave
Plainfield, CT 06374-1036
Phone (860) 564-4081

Other providers in Plainfield, CT

All providers in Plainfield, CT · Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.