Provider Demographics
NPI:1073004024
Name:RIDGEFIELD SENSORY CLINIC LLC
Entity Type:Organization
Organization Name:RIDGEFIELD SENSORY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GIORDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-894-5230
Mailing Address - Street 1:79 DANBURY RD STE A1
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4023
Mailing Address - Country:US
Mailing Address - Phone:203-894-5230
Mailing Address - Fax:203-894-5131
Practice Address - Street 1:79 DANBURY RD STE A1
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4023
Practice Address - Country:US
Practice Address - Phone:203-894-5230
Practice Address - Fax:203-894-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy