Provider Demographics
NPI:1700256708
Name:BIG LEAPS
Entity Type:Organization
Organization Name:BIG LEAPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SNEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSALIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:203-614-9382
Mailing Address - Street 1:999 SUMMER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5546
Mailing Address - Country:US
Mailing Address - Phone:203-614-9382
Mailing Address - Fax:
Practice Address - Street 1:999 SUMMER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5546
Practice Address - Country:US
Practice Address - Phone:203-614-9382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0091832251P0200X
CT004435225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty