Provider Demographics
NPI:1104109867
Name:TARTAGLIA, JANELL (DPT, PCS)
Entity type:Individual
Prefix:MRS
First Name:JANELL
Middle Name:
Last Name:TARTAGLIA
Suffix:
Gender:F
Credentials:DPT, PCS
Other - Prefix:MISS
Other - First Name:JANELL
Other - Middle Name:
Other - Last Name:MANCINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:61 PARK RD
Mailing Address - Street 2:
Mailing Address - City:BARKHAMSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06063-4119
Mailing Address - Country:US
Mailing Address - Phone:203-788-0009
Mailing Address - Fax:860-777-1067
Practice Address - Street 1:259 ALBANY TPKE STE 5
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2557
Practice Address - Country:US
Practice Address - Phone:203-788-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT076572OtherGROUP MEDICARE ID