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Individual

LORRAINE C COSTANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
17 OAKLEDGE CIR, NORWALK, CT 06854-2514
(203) 912-0759
Mailing address
17 OAKLEDGE CIR, NORWALK, CT 06854-2514
(203) 912-0759

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004405
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225100000X
CT
Enumeration date
04/25/2016
Last updated
04/25/2016
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