Provider Demographics
NPI:1619182516
Name:MALATESTA, MARGHERITA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGHERITA
Middle Name:MARIE
Last Name:MALATESTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 DUNK ROCK RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2511
Mailing Address - Country:US
Mailing Address - Phone:203-789-3271
Mailing Address - Fax:203-867-5254
Practice Address - Street 1:175 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4301
Practice Address - Country:US
Practice Address - Phone:203-789-3271
Practice Address - Fax:203-867-5254
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist