Provider Demographics
NPI:1467700310
Name:CARBONI, CARAMARIE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CARAMARIE
Middle Name:
Last Name:CARBONI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2417
Mailing Address - Country:US
Mailing Address - Phone:203-516-5160
Mailing Address - Fax:
Practice Address - Street 1:1 RESERVOIR OFFICE PARK STE 104
Practice Address - Street 2:1449 OLD WATERBURY RD.
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3926
Practice Address - Country:US
Practice Address - Phone:203-262-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003229174400000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist