Provider Demographics
NPI:1184029472
Name:CT RECOVERY, PC
Entity Type:Organization
Organization Name:CT RECOVERY, PC
Other - Org Name:START FRESH RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-856-6878
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-208-7120
Mailing Address - Fax:203-208-7121
Practice Address - Street 1:148 EAST AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5721
Practice Address - Country:US
Practice Address - Phone:203-208-7120
Practice Address - Fax:203-208-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13070208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1730224437OtherCOMMERCIAL INSURANCE