Provider Demographics
NPI:1558347740
Name:CITSAY, NOAH STEPHEN (MSPT, CSCS)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:STEPHEN
Last Name:CITSAY
Suffix:
Gender:M
Credentials:MSPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 POST RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1169
Mailing Address - Country:US
Mailing Address - Phone:203-307-4690
Mailing Address - Fax:
Practice Address - Street 1:3530 POST RD STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1169
Practice Address - Country:US
Practice Address - Phone:203-307-4690
Practice Address - Fax:203-307-4691
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0075762251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic