Provider Demographics
NPI:1285840496
Name:HOSPITAL OF ST. RAHPAEL
Entity Type:Organization
Organization Name:HOSPITAL OF ST. RAHPAEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THEARPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:VAUGHAN
Authorized Official - Last Name:PIKAART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:204-789-5120
Mailing Address - Street 1:84 CLEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1574
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:84 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3009
Practice Address - Country:US
Practice Address - Phone:203-789-5120
Practice Address - Fax:203-488-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002204261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy