Provider Demographics
NPI: | 1821757147 |
---|---|
Name: | REHAB IT PHYSICAL THERAPY PC |
Entity Type: | Organization |
Organization Name: | REHAB IT PHYSICAL THERAPY PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICAL THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HELEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REICH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT |
Authorized Official - Phone: | 203-952-6020 |
Mailing Address - Street 1: | 67 SUMMIT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | RIVERSIDE |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06878-2105 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 203-952-6020 |
Mailing Address - Fax: | 212-223-0198 |
Practice Address - Street 1: | 67 SUMMIT RD |
Practice Address - Street 2: | |
Practice Address - City: | RIVERSIDE |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06878-2105 |
Practice Address - Country: | US |
Practice Address - Phone: | 203-952-6020 |
Practice Address - Fax: | 212-223-0198 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-12-14 |
Last Update Date: | 2021-12-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |