Provider Demographics
NPI:1184797318
Name:GITELMAN, SVETLANA (PT)
Entity type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:GITELMAN
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 1:37 RICHMOND LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1627
Mailing Address - Country:US
Mailing Address - Phone:860-236-7986
Mailing Address - Fax:
Practice Address - Street 1:100 WELLS ST
Practice Address - Street 2:#1B
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-2928
Practice Address - Country:US
Practice Address - Phone:860-525-2672
Practice Address - Fax:860-727-0897
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist