Provider Demographics
NPI:1194205906
Name:PREZIOSO, JOCELYN ROSE (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:ROSE
Last Name:PREZIOSO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:ROSE
Other - Last Name:CERUTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 FLANDERS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1306
Mailing Address - Country:US
Mailing Address - Phone:860-302-2885
Mailing Address - Fax:
Practice Address - Street 1:72 PINE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6960
Practice Address - Country:US
Practice Address - Phone:860-585-5800
Practice Address - Fax:860-585-5840
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2965262251X0800X
CT11912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty