Individual
MARYELLEN BURSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 N MAIN ST, WEST HARTFORD, CT 06107-1933
(860) 561-3960
Mailing address
33 OLD STONE XING, WEST SIMSBURY, CT 06092-2820
(860) 408-1353
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005360
LICENSE#
CT
Enumeration date
11/28/2006
Last updated
07/08/2007
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