Provider Demographics
NPI:1053470492
Name:CPTE - MANCHESTER, INC.
Entity Type:Organization
Organization Name:CPTE - MANCHESTER, INC.
Other - Org Name:CENTER FOR PHYSICAL THERAPY & EXERCISE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASTODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-880-0448
Mailing Address - Street 1:522 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1019
Mailing Address - Country:US
Mailing Address - Phone:603-880-0448
Mailing Address - Fax:603-881-5280
Practice Address - Street 1:20 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4405
Practice Address - Country:US
Practice Address - Phone:603-626-0760
Practice Address - Fax:603-623-7441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NA1183OtherHARVARD PILGRIM
NH306508Medicare ID - Type UnspecifiedMEDICARE