Organization
EASTER SEAL REHABILITATION CENTER
Active
Other names
Easter Seals Waterbury
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORAINE SHEA (PRESIDENT)
(203) 754-5141
Entity
Organization
Contact information
Practice address
22 TOMPKINS ST, WATERBURY, CT 06708-1417
(203) 574-5141
(202) 757-1198
Mailing address
22 TOMPKINS ST, WATERBURY, CT 06708-1417
(203) 574-5141
(202) 757-1198
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004015061
—
CT
05
—
004039657
—
CT
01
—
017500
CONNECTICARE-AUDIOLOGY
CT
01
—
04154
HEARUSA-AUDIOLOGY
CT
01
—
04731
HEARUSA-AUDIOLOGY
CT
01
—
12DME0601CT01
BCBS-DME
CT
01
—
185832
PREFERRED ONE-HUSKY
CT
01
—
246000
CONNECTICARE-AUDIOLOGY
CT
01
—
296184
WELLCARE
CT
01
—
3561698
AETNA-AUDIOLOGY
CT
01
—
43MDE0003CT01
BLUE CROSS BLUE SHIELD
CT
01
—
5617574
AETNA-AUDIOLOGY
CT
01
—
68BT03016CT01
BCBS-BIRTH TO THREE
CT
01
—
800009105CT01
BLUE CROSS BLUE SHIELD
CT
01
—
OR2189
HEALTHNET
CT
Enumeration date
08/28/2006
Last updated
07/27/2016
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