Individual
LISA D FIASCONARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1715 ELLINGTON RD, SOUTH WINDSOR, CT 06074-2707
(860) 644-4408
Mailing address
4 DAISY LN, ELLINGTON, CT 06029-3240
(860) 416-9986
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001835
CT
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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