Provider Demographics
NPI:1275961690
Name:PEDZINSKA, PATRYCJA MARTA (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:PATRYCJA
Middle Name:MARTA
Last Name:PEDZINSKA
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 AMITY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2258
Mailing Address - Country:US
Mailing Address - Phone:203-389-8177
Mailing Address - Fax:203-387-9447
Practice Address - Street 1:245 AMITY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2258
Practice Address - Country:US
Practice Address - Phone:203-389-8177
Practice Address - Fax:203-387-9447
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003965225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist