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Contact Information

JEREMY GAGNON
50 BEACH RD
WOLCOTT, CT06716-1902
 Phone: 203-879-8066
 Fax: 203-879-8484
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JEREMY GAGNON · (Male)

NPI # 1326394610
Status Active
Credentials
Entity Individual
Enumeration date 07/24/2012
Last updated 07/24/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 006374
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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