Provider Demographics
NPI:1821178443
Name:CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-752-7878
Mailing Address - Street 1:46 PRINCE ST
Mailing Address - Street 2:SUITE 402B
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1600
Mailing Address - Country:US
Mailing Address - Phone:203-752-7878
Mailing Address - Fax:203-776-4989
Practice Address - Street 1:6 BUSINESS PARK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2988
Practice Address - Country:US
Practice Address - Phone:203-483-7979
Practice Address - Fax:203-483-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCG2786OtherRAILROAD MEDICARE
0578042OtherAETNA
2V4683OtherHEALTHNET
0114901OtherORTHONET
2V8124OtherHEALTH NET 9/1/06
50HAVLICECT01OtherBCBS
2V4683OtherHEALTHNET