Individual
MRS. KELLY JEAN ANETRELLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
241 BROAD ST, MERIDEN, CT 06450-5877
(203) 440-9880
(203) 440-9881
Mailing address
241 BROAD ST, MERIDEN, CT 06450-5877
(203) 440-9880
(203) 440-9881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006419
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006419CT05
ANTHEM PROVIDER ID
CT
01
—
7285170
AETNA PROVIDER ID
CT
Enumeration date
06/25/2006
Last updated
07/10/2007
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