Provider Demographics
NPI:1073526034
Name:ASSOCIATED PHYSIATRISTS, PC
Entity Type:Organization
Organization Name:ASSOCIATED PHYSIATRISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-444-4739
Mailing Address - Street 1:PO BOX 2118
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-1518
Mailing Address - Country:US
Mailing Address - Phone:860-444-4739
Mailing Address - Fax:860-442-0262
Practice Address - Street 1:365 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4700
Practice Address - Country:US
Practice Address - Phone:860-444-4739
Practice Address - Fax:860-442-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
300041OtherACS/HEALTHNET
740835OtherCONNECTICARE
300041OtherACS/HEALTHNET
CTC00677Medicare PIN