Provider Demographics
NPI:1770227845
Name:SHOMSKY, CARLY (OTR)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SHOMSKY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 REED LN
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5144
Mailing Address - Country:US
Mailing Address - Phone:203-922-2358
Mailing Address - Fax:
Practice Address - Street 1:100 BEARD SAWMILL RD STE 360
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6151
Practice Address - Country:US
Practice Address - Phone:475-239-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5816225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist