Provider Demographics
NPI:1598891525
Name:SEGNERE, DONNA LYNN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LYNN
Last Name:SEGNERE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1641
Mailing Address - Country:US
Mailing Address - Phone:203-421-0660
Mailing Address - Fax:203-421-8448
Practice Address - Street 1:2351 BOSTON POST RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-4360
Practice Address - Country:US
Practice Address - Phone:203-453-4321
Practice Address - Fax:203-453-4322
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist