MRS. CAROL DAVIDSON FORTIN (NPI# 1053799205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053799205 |
| Entity Type | Individual |
| Full Name | MRS. CAROL DAVIDSON FORTIN |
| Credential | PT |
| Practice Address |
22 Masonic Ave Wallingford CT 06492-3048 |
| Practice Telephone | 2036795959 |
| Mailing Telephone | 2036795959 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
001688 | CT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
22 MASONIC AVE |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-3048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689836 | Masonic Healthcare Center | Pharmacy | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-06-16 |
| 1841805397 | Nicholas Metaxas | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-09-11 |
| 1841813102 | Elena Bochicchio | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-05-21 |
| 1245852151 | Annemieke Ausloos Martino | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-05-13 |
| 1457992216 | Alison Lorusso | Nurse Practitioner | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-10-03 |
| 1467014183 | Debbra Konopaske | Physical Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-07-02 |
| 1306305776 | Sarnia Scarlett | Occupational Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-15 |
| 1902364888 | Elizabeth Fox | Speech-Language Pathologist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-09 |
| 1891253415 | Kathleen Robak | Occupational Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-04 |
| 1558831941 | Jeffrey Raymond Necio | Pharmacist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2018-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295926095 | Amy B Harper | Physical Therapist | 116 S Providence Rd, Wallingford, PA 19086-6332 | 2007-08-06 |
| 1558518993 | Jamie Lyn Fitzgibbons | Physical Therapist | 22 Masonic Ave, Masonic Healthcare Center, Wallingford, CT 06492-3048 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174902381 | Lynnette Dufresne | Physical Therapist | 84 Brown St, Hamden, CT 06518-2102 | 2015-05-20 |
| 1205234101 | Alden Alleyne | Physical Therapist | 126 Carey Ave, Meriden, CT 06451-1907 | 2014-12-09 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1598009177 | Body Flex Physical Therapy LLC | Physical Therapist | 28 Kristen Dr, Portland, CT 06480-1153 | 2012-11-20 |
| 1083848220 | Personal Therapy and Home Safety, LLC | Physical Therapist | 129 Coldbrook Rd, South Glastonbury, CT 06073-2709 | 2009-05-02 |
| 1477723716 | Lesley May Pincince | Physical Therapist | 330 Amity Rd, Woodbridge, CT 06525-2131 | 2008-03-03 |
| 1730357294 | Anna Antonovsky Rojek | Physical Therapist | 31 W Maxwell Dr, West Hartford, CT 06107-1442 | 2008-02-18 |
| 1760600860 | Paula Bishop | Physical Therapist | 1157 Highland Ave, Suite 101, Cheshire, CT 06410-1600 | 2007-04-23 |
| 1649304643 | Michael Joseph Catuccio | Physical Therapist | 2 Case Cir, West Simsbury, CT 06092-2200 | 2007-03-14 |
| 1710993597 | William F. Burke Jr. | Physical Therapist | 70 Rosewood Dr, Suffield, CT 06078-2014 | 2006-07-31 |
| Find all providers with the same taxonomy | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
Please comment or provide details below to improve the information on MRS. CAROL DAVIDSON FORTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.