Provider Demographics
NPI:1912547241
Name:NOUJAIM, CRYSTEL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CRYSTEL
Middle Name:
Last Name:NOUJAIM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SHORTWOODS RD
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-3218
Mailing Address - Country:US
Mailing Address - Phone:203-232-9778
Mailing Address - Fax:
Practice Address - Street 1:121 CODFISH HILL RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-3203
Practice Address - Country:US
Practice Address - Phone:203-644-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist