Provider Demographics
NPI:1124632237
Name:DELGRECO, CARLEEN (DPT)
Entity type:Individual
Prefix:DR
First Name:CARLEEN
Middle Name:
Last Name:DELGRECO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CLYDESDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3508
Mailing Address - Country:US
Mailing Address - Phone:603-785-0608
Mailing Address - Fax:
Practice Address - Street 1:705 BOSTON POST RD STE 5A
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2733
Practice Address - Country:US
Practice Address - Phone:203-458-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12769225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist