NPI 1629134945

Lisa Ann Mammano, MSRPT

Practitioner Specialist Madison, CT

Practice location

Address: 23 Woodland Rd, Madison, CT 06443
Phone: (203) 245-9293
Fax: (203) 245-2522
Mailing address: 23 Woodland Rd, Madison, CT 06405

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 006580 (CT)

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Registry record

NPI: 1629134945
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Dec 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.