Provider Demographics
NPI:1962377861
Name:DEGENNARO, FRANCIS ANTHONY III (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:DEGENNARO
Suffix:III
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BROOKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1001
Mailing Address - Country:US
Mailing Address - Phone:203-526-9509
Mailing Address - Fax:
Practice Address - Street 1:191 BROOKSIDE LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1001
Practice Address - Country:US
Practice Address - Phone:203-526-9509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty