Provider Demographics
NPI:1679675284
Name:CERTO, CATHERINE M (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:CERTO
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 1:136 THISTLE POND DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1691
Mailing Address - Country:US
Mailing Address - Phone:860-726-9297
Mailing Address - Fax:
Practice Address - Street 1:200 BLOOMFIELD AVE
Practice Address - Street 2:ATHLETIC COMPLEX
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1545
Practice Address - Country:US
Practice Address - Phone:860-768-5335
Practice Address - Fax:860-768-7892
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist