Individual
SUSAN PEPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
(860) 378-1160
Mailing address
75 NORTON RD, KENSINGTON, CT 06037-2918
(860) 828-3956
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1684
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080001684CT02
BLUE HEALTHCARE INSURANCE
CT
01
—
11244001
CAQH
CT
01
—
XV4914
HEALTHNET
CT
Enumeration date
03/16/2007
Last updated
07/08/2007
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