Gina Mentone
Individual provider Active NPI Athletic Trainer · North Branford, CT
NPI 1801424635 · NPPES record last updated Mar 28, 2020
Key facts
- NPI
- 1801424635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 000517 (CT)
- Practice address
- 22 Wood Chase LN
North Branford, CT 06471-1054 - Phone
- (203) 410-4729
- NPI assigned
- Mar 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 000517 | CT | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000517 | CT | Yes |
Addresses
Primary practice location
22 Wood Chase LN
North Branford, CT 06471-1054
Mailing address
22 Wood Chase LN
North Branford, CT 06471-1054
Phone (203) 410-4729
Other providers in North Branford, CT
- Ann Jennings Maley
- Joseph Anthony Manzella-Kane
- Hallie Elizabeth Mathia
- Maxi Drug Inc
- Alyssa Meier
- Mindset for Success Therapy LLC
- Luis Moren
- Ryan Patrick Moriarty
- Linda J Morrell
- John Richard Murphy
All providers in North Branford, CT · Athletic Trainer in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 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.