Gretchen Pettinico in Waterbury - Pediatrics
Gretchen Pettinico - NPI 1063602712
Gretchen Pettinico is a Pediatrics in Waterbury, Connecticut. Gretchen Pettinico practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Gretchen Pettinico is 1063602712. The last update date is 2007-07-30.
Gretchen Pettinico's current location address is 1389 W Main St Ste 225, Waterbury, Connecticut. You can contact this provider via phone number 2037571474 and fax number 2037571474. The mailing address for Gretchen Pettinico is 1389 W Main St Ste 225, Waterbury, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gretchen Pettinico |
|---|---|
| Address | 1389 W Main St Ste 225, Waterbury, Connecticut |
| Phone Number | 2037571474 |
| Fax Number | 2037571474 |
| Sole Proprietor | N |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1063602712 |
|---|---|
| Provider Enumeration Date | 2007-07-30 |
| Last Updated Date | 2007-07-30 |
Provider Mailing Address Detail
| Address | 1389 W Main St Ste 225 |
|---|---|
| City | Waterbury |
| State | Connecticut (CT) |
| Post Code | 67083115 |
| Phone Number | 2037571474 |
| Fax Number | 2037571474 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | 6403 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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What is the unique 10-digit identification code issued to Gretchen Pettinico by the Centers for Medicare & Medicaid Services?
The Gretchen Pettinico has been assigned the NPI (National Provider Identifier) 1063602712 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Gretchen Pettinico is geographically located?
The Gretchen Pettinico is physically situated at the following location: 1389 W Main St Ste 225, Waterbury, CT, 67083115.
What is Gretchen Pettinico's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Gretchen Pettinico is Pediatrics, and the taxonomy classification code that categorizes this area of expertise is 2251P0200X.
On what date did the Centers for Medicare & Medicaid Services assign the 1063602712 to Gretchen Pettinico?
The Centers for Medicare & Medicaid Services assigned the 1063602712 to Gretchen Pettinico on 2007-07-30.
As of what date were the Gretchen Pettinico's details last updated?
The information pertaining to the Gretchen Pettinico, including its address, specialty, and other details, was most recently updated on 2007-07-30.
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