Provider Demographics
NPI:1013926013
Name:TARINELLI, ROBYN J (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:J
Last Name:TARINELLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2B LEE RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:CT
Mailing Address - Zip Code:06351-3042
Mailing Address - Country:US
Mailing Address - Phone:860-376-2564
Mailing Address - Fax:860-376-4812
Practice Address - Street 1:28 LEE RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:CT
Practice Address - Zip Code:06351-3015
Practice Address - Country:US
Practice Address - Phone:860-376-2564
Practice Address - Fax:860-376-4812
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080006891CT02OtherANTHEM BCBS
CT080006891CT05OtherANTHEM BCBS
CT080006891CT06OtherANTHEM BCBS
CT080006891CT03OtherANTHEM BCBS
CT004217429Medicaid
CT080006891CT07OtherANTHEM BCBS
CT004217429Medicaid