Provider Demographics
NPI:1821645300
Name:SINNEMA, OLGA (DPT)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:SINNEMA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:TERESHCHUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:435 HARTFORD TPKE STE U
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4834
Mailing Address - Country:US
Mailing Address - Phone:860-979-1611
Mailing Address - Fax:860-263-0986
Practice Address - Street 1:230 MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078
Practice Address - Country:US
Practice Address - Phone:860-668-9589
Practice Address - Fax:860-668-9802
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT012328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist