Provider Demographics
NPI:1427856293
Name:MANGOLD, ALESSANDRA NICOLE (OTR)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:NICOLE
Last Name:MANGOLD
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2231
Mailing Address - Country:US
Mailing Address - Phone:203-273-6928
Mailing Address - Fax:
Practice Address - Street 1:160 VALLEY RD
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2231
Practice Address - Country:US
Practice Address - Phone:203-273-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist