Provider Demographics
NPI:1437129608
Name:BADE, GRETCHEN (PT)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:
Last Name:BADE
Suffix:
Gender:F
Credentials:PT
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Other - Last Name:
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Mailing Address - Street 1:181 PATRICIA GENOVA DRIVE
Mailing Address - Street 2:EASTERN REHABILITATION NETWORK 5TH FLOOR
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111
Mailing Address - Country:US
Mailing Address - Phone:860-667-5449
Mailing Address - Fax:860-667-8416
Practice Address - Street 1:1060 DAYHILL ROAD
Practice Address - Street 2:EASTERN REHABILITATION NETWORK 5TH FLOOR
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095
Practice Address - Country:US
Practice Address - Phone:860-688-0236
Practice Address - Fax:860-688-0403
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT006047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist