Provider Demographics
NPI:1639129935
Name:EXCEL PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:EXCEL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DATNA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:BUSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:203-288-6977
Mailing Address - Street 1:2285 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-288-6977
Mailing Address - Fax:203-230-8444
Practice Address - Street 1:2285 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-288-6977
Practice Address - Fax:203-230-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0102301OtherORTHONET HEALTHNET
CT080004966CT02OtherANTHEM BLUE CROSS/BLUE SH
CTA3184524OtherOXFORD
CT3001821OtherCIGNA
CT3567925OtherAETNA
2V8129OtherHEALTHNET
CT6605951OtherGHI
CT682977OtherACN GROUP
CT0102301OtherORTHONET HEALTHNET
CT3001821OtherCIGNA