Individual
AMY T MOORADIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1666 ROUTE 12, GALES FERRY, CT 06335-1541
(860) 941-9126
Mailing address
12 BEACON HILL DR, WATERFORD, CT 06385-4108
(860) 910-9571
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009106
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050513332
GREATWEST
RI
01
—
103959900
USDE
RI
01
—
26848
BLUE CROSS BLUE SHIELD RI
RI
01
—
268480
BLUE CROSS PROVIDER NUMBE
RI
01
—
411015
BLUE CHIP RI
RI
01
—
5669517
COVENTRY HEALTH FIRST HEA
RI
01
—
779850
AETNA
RI
01
—
9378895
PHCS
RI
01
—
AA1566
PILGRIM
RI
01
—
P00322419
MEDICARE RAILROAD
RI
Enumeration date
09/23/2005
Last updated
12/16/2021
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