Agnes Matug, OT ASSISTANT

Individual provider Active NPI Occupational Therapy Assistant · East Berlin, CT

NPI 1245735232 · NPPES record last updated Mar 7, 2024

Key facts

NPI
1245735232
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
001397 (CT)
Practice address
44 Wilcox Ave
East Berlin, CT 06023-1010
Phone
(860) 829-6774
NPI assigned
Mar 29, 2018
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 001397 CT Yes

Addresses

Primary practice location

44 Wilcox Ave
East Berlin, CT 06023-1010

Mailing address

44 Wilcox Ave
East Berlin, CT 06023-1010
Phone (860) 810-5487

Other providers in East Berlin, CT

All providers in East Berlin, CT · Occupational Therapy Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.