Provider Demographics
NPI:1639650930
Name:STAMFORD ACQUISITION I, LLC
Entity Type:Organization
Organization Name:STAMFORD ACQUISITION I, LLC
Other - Org Name:CASSENA CARE AT STAMFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-422-7817
Mailing Address - Street 1:53 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3401
Mailing Address - Country:US
Mailing Address - Phone:203-351-8300
Mailing Address - Fax:631-792-1341
Practice Address - Street 1:53 COURTLAND AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3401
Practice Address - Country:US
Practice Address - Phone:203-351-8300
Practice Address - Fax:631-792-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy