Provider Demographics
NPI:1306932637
Name:OBENZA, CASSANDRA JEANNE DEL CASTILLO (RPT)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA JEANNE
Middle Name:DEL CASTILLO
Last Name:OBENZA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1183 NEW HAVEN RD
Mailing Address - Street 2:STE 206
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-5033
Mailing Address - Country:US
Mailing Address - Phone:646-240-5503
Mailing Address - Fax:
Practice Address - Street 1:1183 NEW HAVEN RD
Practice Address - Street 2:STE 206
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-5033
Practice Address - Country:US
Practice Address - Phone:203-729-2344
Practice Address - Fax:203-729-2355
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT007551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist