Doctor Name: | MR. MATTHEW CALENDRILLO |
NPI Number: | 1043475098 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT, BOCO |
License Number: | 007740 |
Business Practice Address: | 68 Bridge Street Suite 111 Suffield, CT - 060783107 |
Business Phone Number: | 8602545190 |
Business Fax Number: | 8602545190 |
Mailing Address: | 68 Bridge St, Suite 111 SUFFIELD |
State: | CT |
Postal Code: | 060783107 |
Phone Number: | 8602545190 |
Fax Number: | 8602545190 |
NPI Enumeration Date: | 07/18/2008 |
NPI Last Update Date: | 08/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 007740 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |