Individual
SVETLANA MEDVED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
745 MAIN ST, EAST HARTFORD, CT 06108-3115
(860) 289-2791
Mailing address
46 HAYNES RD, WEST HARTFORD, CT 06117-2730
(860) 289-2791
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
075257
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075257
RIVERSIDE HEALTH AND REHAB
CT
Enumeration date
05/04/2015
Last updated
05/04/2015
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