Provider Demographics
NPI:1811106107
Name:SZOLLOSY, JANE MARIE (RPT)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MARIE
Last Name:SZOLLOSY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 WESTSIDE RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4332
Mailing Address - Country:US
Mailing Address - Phone:860-482-8553
Mailing Address - Fax:
Practice Address - Street 1:225 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6043
Practice Address - Country:US
Practice Address - Phone:860-482-8563
Practice Address - Fax:860-489-3848
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist