Taylor Benson, ATC, LAT, EMT

Individual provider Active NPI Athletic Trainer · Norwalk, CT

NPI 1154860161 · NPPES record last updated Feb 23, 2017

Key facts

NPI
1154860161
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2000025287 (CT)
Practice address
490 Westport Ave
Norwalk, CT 06851-4424
Phone
(203) 614-9635
NPI assigned
Feb 23, 2017
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)
No
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
2000025287CTMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000025287 CT Yes

Addresses

Primary practice location

490 Westport Ave
Norwalk, CT 06851-4424

Mailing address

490 Westport Ave
Norwalk, CT 06851-4424
Phone (203) 614-9635

Other providers in Norwalk, CT

All providers in Norwalk, CT · Athletic Trainer in Connecticut

Sources for this page

Verify at the official NPI Registry.