Provider Demographics
NPI:1033120910
Name:IANIGRO-BLINN, HILDA S (PT)
Entity Type:Individual
Prefix:MS
First Name:HILDA
Middle Name:S
Last Name:IANIGRO-BLINN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:HILDA
Other - Middle Name:S
Other - Last Name:IANIGRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 WESTWOOD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2460
Mailing Address - Country:US
Mailing Address - Phone:203-597-1609
Mailing Address - Fax:203-597-1581
Practice Address - Street 1:60 WESTWOOD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2460
Practice Address - Country:US
Practice Address - Phone:203-597-1609
Practice Address - Fax:203-597-1581
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT004278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist