Provider Demographics
NPI:1265503684
Name:LOVIG, ANDREW S (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:LOVIG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2564
Mailing Address - Country:US
Mailing Address - Phone:203-268-3478
Mailing Address - Fax:
Practice Address - Street 1:999 SUMMER ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5546
Practice Address - Country:US
Practice Address - Phone:203-359-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017214225100000X
DE#J1-0001867225100000X
CT008015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist