Organization
MASONICARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNA LANDINO (REGISTERED OCCUPATIONAL THERAPIST)
(203) 679-6329
Entity
Organization
Contact information
Practice address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-6329
Mailing address
22 MASONIC AVENUE, WALLINGFORD, CT 06492
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
060655131
CT
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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