Organization
CENTER FOR PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA RUSCILLO (SPEECH AND LANGUAGE PATHOLOGIST)
(203) 949-9337
Entity
Organization
Contact information
Practice address
1300 POST RD STE 204, FAIRFIELD, CT 06824-6038
(203) 255-3669
(203) 254-3790
Mailing address
101 N PLAINS INDUSTRIAL RD, WALLINGFORD, CT 06492-2360
(203) 949-9337
(203) 284-3779
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004880
CT
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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