Provider Demographics
NPI:1548445745
Name:DUPERE, TATIANA N (RPT REGISTERED PHYSI)
Entity type:Individual
Prefix:MRS
First Name:TATIANA
Middle Name:N
Last Name:DUPERE
Suffix:
Gender:F
Credentials:RPT REGISTERED PHYSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:470 PINEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1644
Mailing Address - Country:US
Mailing Address - Phone:413-567-2170
Mailing Address - Fax:
Practice Address - Street 1:93 WATERBURY ROAD
Practice Address - Street 2:RIFKIN PHYSICAL THERAPY AND LYMPHEDEMA CENTER LLC
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1482
Practice Address - Country:US
Practice Address - Phone:203-758-6569
Practice Address - Fax:203-758-0443
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT006528225100000X
MA15050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist