Provider Demographics
NPI:1275717225
Name:DINO, ANNIE M (PT)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:M
Last Name:DINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-866-5458
Mailing Address - Fax:203-354-6182
Practice Address - Street 1:195 DANBURY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4075
Practice Address - Country:US
Practice Address - Phone:203-834-8884
Practice Address - Fax:203-563-9675
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT004377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist