Provider Demographics
NPI:1275208118
Name:CARIGLIO, SHAWN LAWRENCE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:LAWRENCE
Last Name:CARIGLIO
Suffix:
Gender:M
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 1:189 ALPS RD # 4771
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4798
Mailing Address - Country:US
Mailing Address - Phone:203-481-6221
Mailing Address - Fax:
Practice Address - Street 1:189 ALPS RD # 4771
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4798
Practice Address - Country:US
Practice Address - Phone:203-481-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5285225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5285OtherOCCUPATIONAL THERAPY LICENSE