Provider Demographics
NPI:1093170839
Name:GELARDI, CHRISTINA MAGNOLIA I (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MAGNOLIA
Last Name:GELARDI
Suffix:I
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 MARSHALL LN
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-2329
Mailing Address - Country:US
Mailing Address - Phone:203-308-0583
Mailing Address - Fax:
Practice Address - Street 1:194 MARSHALL LN
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-2329
Practice Address - Country:US
Practice Address - Phone:203-308-0583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004544225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation