Provider Demographics
NPI:1326128331
Name:SIMONDS, JANE ERIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ERIN
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:ERIN
Other - Last Name:LINDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 831
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06018
Mailing Address - Country:US
Mailing Address - Phone:860-824-4786
Mailing Address - Fax:
Practice Address - Street 1:99 SOUTH CANAAN ROAD
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06018
Practice Address - Country:US
Practice Address - Phone:860-824-3820
Practice Address - Fax:860-824-5462
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
075202Medicare ID - Type Unspecified