Provider Demographics
NPI:1992922504
Name:PARENTE, MATTHEW ANTHONY (PT, CPO)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ANTHONY
Last Name:PARENTE
Suffix:
Gender:M
Credentials:PT, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:184 NEW STATE RD
Mailing Address - Street 2:APT. #38
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-7943
Mailing Address - Country:US
Mailing Address - Phone:860-643-9926
Mailing Address - Fax:516-759-1666
Practice Address - Street 1:184 NEW STATE RD
Practice Address - Street 2:APT. #38
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-7943
Practice Address - Country:US
Practice Address - Phone:860-643-9926
Practice Address - Fax:516-759-1666
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist