Individual
KATHRYN MARIE MALATESTINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1500 LEXINGTON BLVD, BETHEL, CT 06801-1338
(203) 240-7122
Mailing address
2011 VILLAGE VIEW CIR APT 202, BELMONT, NC 28012-3199
(203) 240-7122
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
2000030923
NC
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
05/11/2018
Last updated
08/07/2020
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