Individual
MATTHEW MANGIACOPRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
31 VAUXHALL ST, NEW LONDON, CT 06320
(860) 442-4363
Mailing address
31 VAUXHALL ST, NEW LONDON, CT 06320-5723
(860) 442-4363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3766
CT
Other
Enumeration date
05/05/2016
Last updated
06/16/2019
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