Provencal, Amy
Provencal, Amy is an individual health care provider with primary practice located at 950 Campbell Ave , West Haven CT 06516-2770. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Provencal, Amy can be contacted via phone (203) 935-5711.Contact Information
Primary practice address
950 Campbell Ave
West Haven CT 06516-2770
Phone: (203) 935-5711
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 000199 | Connecticut |
Profile Details
| NPI number | 1255584561 |
|---|---|
| LBN Legal business name | Provencal, Amy |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 30th, 2008 |
| Last updated | Oct 30th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255584561 | NPPES |
| Connecticut | Other | 22520000X | PHYSICAL THERAPY ASSISTANT |
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