Corinna Augusta Clark, PT, DPT
Individual provider Active NPI Physical Therapist · New Haven, CT
NPI 1336995299 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1336995299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 008803 (CT)
- Practice address
- 1450 Chapel St
New Haven, CT 06511-4405 - Phone
- (475) 224-7584
- NPI assigned
- Apr 30, 2024
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008803 | CT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 008803 | CT | Yes |
Addresses
Primary practice location
1450 Chapel St
New Haven, CT 06511-4405
Mailing address
177 East St
Southington, CT 06489-3911
Other providers in New Haven, CT
- Lauren Samantha Claffey
- Claire Isenga Nutrition LLC
- Leslie Clapp
- Augusto Clari
- Brian Joseph Clark
- Genese Calloway Clark
- Helena Jeanette Clark
- Katherine Arlene Arner Clark
- Mitchell Brent Clark
- Terri Patrice Clark
All providers in New Haven, 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 Apr 30, 2024. 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.