Provider Demographics
NPI:1568928679
Name:AUERBACHER, MICHELE MARIE (REHAB DIRECTOR - PTA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:AUERBACHER
Suffix:
Gender:F
Credentials:REHAB DIRECTOR - PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CONE AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-4822
Mailing Address - Country:US
Mailing Address - Phone:203-238-1606
Mailing Address - Fax:
Practice Address - Street 1:33 CONE AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4822
Practice Address - Country:US
Practice Address - Phone:203-238-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1206225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant