Provider Demographics
NPI:1801533740
Name:WRIGHT, GREGORY DAVID JR (OT)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:DAVID
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 STRAITS TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1841
Mailing Address - Country:US
Mailing Address - Phone:203-577-2002
Mailing Address - Fax:203-577-2060
Practice Address - Street 1:1579 STRAITS TPKE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1841
Practice Address - Country:US
Practice Address - Phone:203-577-2002
Practice Address - Fax:203-577-2060
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5973225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist