Provider Demographics
NPI:1750527990
Name:CENTER OF MEDICAL ARTS, L.L.C.
Entity type:Organization
Organization Name:CENTER OF MEDICAL ARTS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAIRJO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:860-225-6666
Mailing Address - Street 1:617 HARTFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1526
Mailing Address - Country:US
Mailing Address - Phone:860-225-6666
Mailing Address - Fax:860-612-1860
Practice Address - Street 1:617 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-1526
Practice Address - Country:US
Practice Address - Phone:860-225-6666
Practice Address - Fax:860-612-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty