Provider Demographics
NPI:1013774702
Name:ZEGARZEWSKI, MADELEINE SIMONE (OTR/L)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:SIMONE
Last Name:ZEGARZEWSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:SIMONE
Other - Last Name:FRANCOEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WATERFORD WAY UNIT 105
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8108
Mailing Address - Country:US
Mailing Address - Phone:401-481-6157
Mailing Address - Fax:
Practice Address - Street 1:2 WATERFORD WAY UNIT 105
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-8108
Practice Address - Country:US
Practice Address - Phone:401-481-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3537225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist