Individual
MS. CECILE PERIGARD PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
(860) 378-1160
Mailing address
100 ROCKLEDGE DR, WATERBURY, CT 06706-2345
(203) 757-2167
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0001501
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080001501CT02
BLUE CROSS
CT
01
—
11244033
CAQH
CT
Enumeration date
03/26/2007
Last updated
07/08/2007
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