Provider Demographics
NPI:1902847965
Name:FESH, MARGARET O (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:O
Last Name:FESH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:OLKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:268 GREENWOOD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2436
Mailing Address - Country:US
Mailing Address - Phone:203-917-4792
Mailing Address - Fax:203-917-4798
Practice Address - Street 1:268 GREENWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2436
Practice Address - Country:US
Practice Address - Phone:203-917-4792
Practice Address - Fax:203-917-4798
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004210233Medicaid