Provider Demographics
NPI:1730628991
Name:SENDRA, KATHERINE GENEVIEVE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GENEVIEVE
Last Name:SENDRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:ZMUDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 SEABURY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2650
Mailing Address - Country:US
Mailing Address - Phone:860-286-0243
Mailing Address - Fax:
Practice Address - Street 1:200 SEABURY DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2650
Practice Address - Country:US
Practice Address - Phone:860-286-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4748225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist