Provider Demographics
NPI:1629557491
Name:PALLADINO, TODD JOSEPH (OTR/L, CLT)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:JOSEPH
Last Name:PALLADINO
Suffix:
Gender:M
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2015
Mailing Address - Country:US
Mailing Address - Phone:860-384-9102
Mailing Address - Fax:
Practice Address - Street 1:3396 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-3812
Practice Address - Country:US
Practice Address - Phone:203-754-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-12
Last Update Date:2018-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1404208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation