Provider Demographics
NPI:1447774062
Name:AMATO, RACHEL T (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:T
Last Name:AMATO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E WADSWORTH PARK DR STE 230
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8096
Mailing Address - Country:US
Mailing Address - Phone:385-308-8034
Mailing Address - Fax:
Practice Address - Street 1:761 MAIN AVE STE 115
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-845-2987
Practice Address - Fax:203-840-0468
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011473225100000X
FLTPPT250225100000X
MA26506225100000X
NY049567225100000X
IL070.027091225100000X
NJ40QA02139400225100000X
CT11473225100000X
TX1370370225100000X
IN05014897A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist