Doctor Name: | MS. MARY I DALLAS |
NPI Number: | 1598709347 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD,PT |
License Number: | 006284 |
Business Practice Address: | 950 Campbell Ave Va Ct Mail Stop 117 West Haven, CT - 065162770 |
Business Phone Number: | 2039325711 |
Business Fax Number: | 2039374707 |
Mailing Address: | 950 Campbell Ave, Va Ct Mail Stop 117 WEST HAVEN |
State: | CT |
Postal Code: | 065162770 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 006284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |