Provider Demographics
NPI:1346290574
Name:GREENWICH PHYSICAL THERAPY CENTER, P.C.
Entity Type:Organization
Organization Name:GREENWICH PHYSICAL THERAPY CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:H
Authorized Official - Last Name:GELBS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:203-637-1700
Mailing Address - Street 1:1171 E PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CT
Mailing Address - Zip Code:06878-1426
Mailing Address - Country:US
Mailing Address - Phone:203-637-1700
Mailing Address - Fax:203-637-5447
Practice Address - Street 1:1171 E PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CT
Practice Address - Zip Code:06878-1426
Practice Address - Country:US
Practice Address - Phone:203-637-1700
Practice Address - Fax:203-637-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT478953OtherAETNA HMO GROUP NUMBER
CT683014OtherUNITED HEALTH CARE / ACN
CTC02823Medicare ID - Type UnspecifiedGROUP PHYSICAL THERAPISTS