Provider Demographics
NPI:1023124971
Name:TOWNSEND-GRANT, SARAH ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:TOWNSEND-GRANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3514
Mailing Address - Country:US
Mailing Address - Phone:203-288-6977
Mailing Address - Fax:203-230-8444
Practice Address - Street 1:2285 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3514
Practice Address - Country:US
Practice Address - Phone:203-288-6977
Practice Address - Fax:203-230-8444
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009070A225100000X
CT008338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN9446203OtherPHCS PID NUMBER
IN000000489401OtherANTHEM PROVIDER NUMBER
IN200832480Medicaid
IN000000489401OtherANTHEM PROVIDER NUMBER
IN200832480Medicaid