Provider Demographics
NPI:1598799587
Name:STEARNS, ERIC J (PT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:STEARNS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HARTFORD TPKE
Mailing Address - Street 2:SUITE U
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4852
Mailing Address - Country:US
Mailing Address - Phone:860-979-1611
Mailing Address - Fax:203-866-3014
Practice Address - Street 1:586 MIDDLE TPKE E
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3730
Practice Address - Country:US
Practice Address - Phone:860-645-3810
Practice Address - Fax:860-645-3814
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000779Medicare ID - Type Unspecified