Individual
MRS. COLLEEN B. WEITEKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
33 CHURCH HILL RD, NEWTOWN, CT 06470-1637
(475) 828-0932
(475) 209-8054
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006609
CT
2251P0200X
Pediatric Physical Therapist
006609
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021239-1
—
NY
Enumeration date
06/07/2006
Last updated
12/18/2020
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