Provider Demographics
NPI:1639193386
Name:PERROTTA, LOUIS M (CPO)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:M
Last Name:PERROTTA
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 DOWD AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2401
Mailing Address - Country:US
Mailing Address - Phone:860-693-6932
Mailing Address - Fax:
Practice Address - Street 1:141 DOWD AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2401
Practice Address - Country:US
Practice Address - Phone:860-693-6932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management