Provider Demographics
NPI:1396022422
Name:ALLSTAR THERAPY
Entity type:Organization
Organization Name:ALLSTAR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:WENDY
Authorized Official - Last Name:PADRON-COTTO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:203-924-6225
Mailing Address - Street 1:45 MALTBY ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3328
Mailing Address - Country:US
Mailing Address - Phone:203-924-6225
Mailing Address - Fax:
Practice Address - Street 1:45 MALTBY ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3328
Practice Address - Country:US
Practice Address - Phone:203-924-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004240314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility