Penny Barsch

Individual provider Active NPI Occupational Therapy Assistant · Waterbury, CT

NPI 1497062541 · NPPES record last updated Sep 10, 2010

Key facts

NPI
1497062541
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
00189 (CT)
Practice address
22 Tompkins St
Waterbury, CT 06708-1458
Phone
(203) 419-0381
Fax
(203) 419-0389
NPI assigned
Sep 10, 2010
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

LicenseStateTypeSpecialty
00189CTMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 00189 CT Yes

Addresses

Primary practice location

22 Tompkins St
Waterbury, CT 06708-1458

Mailing address

22 Tompkins St
Waterbury, CT 06708-1458
Phone (203) 419-0381

Other identifiers

IdentifierTypeStateIssuer
004190328MedicaidCT

Other providers in Waterbury, CT

All providers in Waterbury, CT · Occupational Therapy Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.