Provider Demographics
NPI:1972848117
Name:BRIGGS-MALANSON, GAIL (PT)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:BRIGGS-MALANSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421B BLACKHAWK LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8131
Mailing Address - Country:US
Mailing Address - Phone:203-623-4051
Mailing Address - Fax:
Practice Address - Street 1:225 AMITY RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2206
Practice Address - Country:US
Practice Address - Phone:203-387-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist