Provider Demographics
NPI:1437256625
Name:BRANFORD REHAB CENTER INC
Entity Type:Organization
Organization Name:BRANFORD REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARENTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:203-488-4368
Mailing Address - Street 1:226 E MAIN ST
Mailing Address - Street 2:P.O. BOX 507
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3103
Mailing Address - Country:US
Mailing Address - Phone:203-488-4368
Mailing Address - Fax:203-488-5034
Practice Address - Street 1:226 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3103
Practice Address - Country:US
Practice Address - Phone:203-488-4368
Practice Address - Fax:203-488-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT2034174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02461Medicare PIN