Individual ProviderAnnemieke Ausloos MartinoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address22 Masonic Ave, Wallingford, CT 06492-3048(203) 679-5900(203) 470-0767PECOS EnrollmentBased on the most recent information from CMS, provider Annemieke Ausloos Martino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1245852151Provider TypeIndividualFull NameMartino, Annemieke AusloosCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date5/13/2020Last Updated5/13/2020Contact InformationPractice LocationPractice Address22 Masonic Ave, Wallingford, CT 06492-3048Phone(203) 679-5900FaxUnlisted FaxMailing LocationMailing Address556 Upper Grassy Hill Rd, Woodbury, CT 06798-3107Phone(203) 470-0767FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense011923Connecticut