Organization
PATHWAYS PHYSICAL THERAPY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY JEAN ANETRELLA P.T. (OWNER)
(203) 440-9880
Entity
Organization
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
261QP2000X
Physical Therapy Clinic/Center
Primary
006419
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400870
ORTHONET PROVIDER IDENTIFIER
CT
01
—
080006419CT05
ANTHEM PROVIDER ID
CT
01
—
7285170
AETNA PROVIDER ID
CT
01
—
C03722
MEDICARE PTAN
CT
01
—
XV0104
HEALTHNET PROVIDER ID
CT
Enumeration date
07/12/2007
Last updated
08/22/2008
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