Marcia A Donofrio, PT

Individual provider Active NPI Physical Therapist · Mansfield Center, CT

NPI 1962691196 · NPPES record last updated Aug 15, 2013

Key facts

NPI
1962691196
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
001450 (CT)
Practice address
175 Stafford Rd
Mansfield Center, CT 06250-1441
Phone
(860) 456-8869
Fax
(860) 450-1936
NPI assigned
Oct 24, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1450CTMDAddiction (Substance Use Disorder) Counselor
001450CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Loving Hands Chiropractic LLC Past
since Jul 6, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 001450 CT Yes

Addresses

Primary practice location

175 Stafford Rd
Mansfield Center, CT 06250-1441

Mailing address

175 Stafford Rd
Mansfield Center, CT 06250-1441
Phone (860) 456-8869

Other identifiers

IdentifierTypeStateIssuer
0116301OtherORTHONET-HEALTHNET
056002OtherCTHEALTH NET
ANC895OtherCTOXFORD
080001450CT02OtherCTBLUE CROSS BLUE SHIELD

Other providers in Mansfield Center, CT

All providers in Mansfield Center, CT · Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.