Provider Demographics
NPI:1689686545
Name:DARIEN PHYSICAL THERAPY CENTER, P.C.
Entity Type:Organization
Organization Name:DARIEN PHYSICAL THERAPY CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, AT, C
Authorized Official - Phone:203-655-6464
Mailing Address - Street 1:455 POST RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-3614
Mailing Address - Country:US
Mailing Address - Phone:203-655-6464
Mailing Address - Fax:203-655-2859
Practice Address - Street 1:455 POST RD STE 201
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3614
Practice Address - Country:US
Practice Address - Phone:203-655-6464
Practice Address - Fax:203-655-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X
CT4300265-000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT52901OtherCIGNA ORTHONET PROVIDER #
CT3502813006OtherCIGNA PROVIDER NUMBER
CT566378OtherAETNA PROVIDER NUMBER
CTQ56091OtherEMPIRE ORTHONET PROVIDER
CTCV9551OtherHEALTHNET PROVIDER NUMBER
CTA3512621OtherOXFORD PROVIDER NUMBER
CTCV9551OtherHEALTHNET PROVIDER NUMBER