Provider Demographics
NPI:1528549821
Name:PERROTTI, LINDSEY (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:PERROTTI
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 1:435 HARTFORD TPKE STE U
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4834
Mailing Address - Country:US
Mailing Address - Phone:860-870-8272
Mailing Address - Fax:
Practice Address - Street 1:12 MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3361
Practice Address - Country:US
Practice Address - Phone:860-872-7500
Practice Address - Fax:860-872-7501
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT011956OtherCT LICENSE