Pamela Wynn, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

000528 Issued in CT

Practice address

301 Rope Ferry Rd
Waterford, CT 06385-2610

Phone

(860) 444-1175

NPI assigned

Jul 31, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1477939429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ROPE FERRY RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852610",
            "telephone_number": "860-444-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ROPE FERRY RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852610",
            "telephone_number": "860-444-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "PAMELA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Yee-Lam Wong, OD
• Ericka C Woods, PHD
• Jeffrey William Worgul, M.S.
• David Wu, PHARM.D.
• Pauline Wyatt, PT
• Y Eyecare LLC
• Amirfarbod Yazdanyar, MD/PHD
• Yellow Cab Company of New London and Groton, Inc.
• Sarah Yetman
• Kiley J Young, LCSW

• Physical Therapy Assistant in Waterford, CT
• Providers in Waterford, CT by specialty
• Physical Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.