Active NPI
Rena Muller Mantegazza, PT
- Physical Therapist
- Bethel, CT
National Provider Identifier
1841587086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003292
- Practice address
- 13 Park Lawn Dr
Bethel, CT 06801-1043 - Phone
- (203) 830-4180
- Fax
- (203) 797-2995
- NPI assigned
- Jul 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003292 | CT | Primary |
Addresses
Primary practice location
13 Park Lawn Dr
Bethel, CT 06801-1043
Mailing address
38 Madeline Dr
Ridgefield, CT 06877-2209
Phone (203) 438-0343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003292 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1841587086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 MADELINE DR",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068772209",
"telephone_number": "203-438-0343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 PARK LAWN DR",
"city": "BETHEL",
"state": "CT",
"postal_code": "068011043",
"telephone_number": "203-830-4180",
"fax_number": "203-797-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTEGAZZA",
"first_name": "RENA",
"middle_name": "MULLER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-08",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "003292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.