Provider Demographics
NPI:1295027589
Name:ADVANCE THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:ADVANCE THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FILOMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RINALDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-577-3700
Mailing Address - Street 1:590 MIDDLEBURY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2562
Mailing Address - Country:US
Mailing Address - Phone:203-577-3700
Mailing Address - Fax:203-577-3800
Practice Address - Street 1:590 MIDDLEBURY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2562
Practice Address - Country:US
Practice Address - Phone:203-577-3700
Practice Address - Fax:203-577-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003769261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center