Provider Demographics
NPI:1407593304
Name:QUATRONI, TINA (LMT)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:QUATRONI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BROAD ST STE 4OFFICE5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4751
Mailing Address - Country:US
Mailing Address - Phone:347-738-1431
Mailing Address - Fax:
Practice Address - Street 1:203 BROAD ST STE 4OFFICE5
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4751
Practice Address - Country:US
Practice Address - Phone:347-738-1431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10727225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist