Provider Demographics
NPI:1285444190
Name:PISCIONIERE, JEFFREY F
Entity type:Individual
Prefix:
First Name:JEFFREY F
Middle Name:
Last Name:PISCIONIERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ARROWHEAD LN
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2030
Mailing Address - Country:US
Mailing Address - Phone:203-521-2649
Mailing Address - Fax:
Practice Address - Street 1:18 ARROWHEAD LN
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-2030
Practice Address - Country:US
Practice Address - Phone:203-521-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist