Provider Demographics
NPI:1467565150
Name:SIEGLINDE LIU PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SIEGLINDE LIU PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIEGLINDE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:P T
Authorized Official - Phone:860-205-9831
Mailing Address - Street 1:35 INVERNESS CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3548
Mailing Address - Country:US
Mailing Address - Phone:203-250-1005
Mailing Address - Fax:203-250-0807
Practice Address - Street 1:1735 POST RD
Practice Address - Street 2:SUITE # 7
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5782
Practice Address - Country:US
Practice Address - Phone:203-256-4733
Practice Address - Fax:203-256-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080004601CT01OtherANTHEM BC/BS
CT2V1326OtherHEALTH NET
CTC02903Medicare ID - Type Unspecified