| Easter Seal Rehabilitation Center | |
|
22 Tompkins St Waterbury CT 06708-1496 | |
| (203) 754-5141 | |
| (203) 757-1198 |
| Full Name | Easter Seal Rehabilitation Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 22 Tompkins St, Waterbury, Connecticut |
| Authorized Official Name and Position | Gary Nielsen (CFO/COO) |
| Authorized Official Contact | 2037545141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seal Rehabilitation Center 22 Tompkins St Waterbury CT 06708-1496 Ph: (203) 754-5141 | Easter Seal Rehabilitation Center 22 Tompkins St Waterbury CT 06708-1496 Ph: (203) 754-5141 |
| NPI Number | 1497054316 |
|---|---|
| Provider Enumeration Date | 03/17/2011 |
| Last Update Date | 06/21/2023 |
| Medicare PECOS PAC ID | 7416864178 |
|---|---|
| Medicare Enrollment ID | O20110623000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497054316 | NPI | - | NPPES |
| 12DME0601CT01 | Other | CT | ANTHEM BLUE CROSS BLUE SHIELD |
| 232000 | Other | CONNECTICARE | |
| 017500 | Other | CT | CONNECTICARE |
| 5376280 | Other | AETNA | |
| 5617574 | Other | CT | AETNA |
| 800009105CT01 | Other | CT | ANTHEM BLUE CROSS BLUE SHIELD |
| Provider Name | Kay Yanagisawa |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1285649616 PECOS PAC ID: 4183786767 Enrollment ID: I20081216000071 |
| Provider Name | Annette A Burton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1437259546 PECOS PAC ID: 9931387859 Enrollment ID: I20110624000026 |
| Provider Name | Allison Phipps |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609227487 PECOS PAC ID: 1557644127 Enrollment ID: I20170206000022 |
| Provider Name | Christa Johnson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1952656639 PECOS PAC ID: 4284881368 Enrollment ID: I20230206002105 |
| Provider Name | Victoria Anna Zysk |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609609460 PECOS PAC ID: 6507306933 Enrollment ID: I20240911003442 |
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