Provider Demographics
NPI:1699333971
Name:HASSETT, CORRINE A (MPA, PT)
Entity type:Individual
Prefix:
First Name:CORRINE
Middle Name:A
Last Name:HASSETT
Suffix:
Gender:F
Credentials:MPA, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAYFIELD TER
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1326
Mailing Address - Country:US
Mailing Address - Phone:860-501-1370
Mailing Address - Fax:
Practice Address - Street 1:10 MAYFIELD TER
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1326
Practice Address - Country:US
Practice Address - Phone:860-501-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000062482251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics