Jillian Cacopardo, MPT
Individual provider Active NPI Physical Therapist · Portland, CT
NPI 1245758697 · NPPES record last updated Aug 24, 2020
Key facts
- NPI
- 1245758697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7065 (CT)
- Practice address
- 14 Jordan LN
Portland, CT 06480-1620 - Phone
- (774) 218-3706
- NPI assigned
- Sep 6, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7065 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart University, Inc | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7065 | CT | Yes |
Addresses
Primary practice location
14 Jordan LN
Portland, CT 06480-1620
Mailing address
14 Jordan LN
Portland, CT 06480-1620
Phone (774) 218-3706
Other practice location 1
201 W High St Ste A-2
East Hampton, CT 06424-2138
Phone (860) 357-5666
Other providers in Portland, CT
- Michele Binezewski
- Body Flex Physical Therapy LLC
- Bordonaro'S Pharmacy Inc.
- Bordonaro'S Pharmacy Inc.
- Rhea Jane Boscolo
- Justin Caskey
- Kelsey Ejzak Caulfield
- Carl CHI
- Cna'S Care LLC
- Janet S. Colonghi
All providers in Portland, 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 Aug 24, 2020. 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.