Provider Demographics
NPI:1811962806
Name:SWAIRJO SPRING, MUNA (RPT)
Entity type:Individual
Prefix:
First Name:MUNA
Middle Name:
Last Name:SWAIRJO SPRING
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE CENTER OF MEDICAL ARTS
Mailing Address - Street 2:617 HARTFORD ROAD
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
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000775Medicare ID - Type Unspecified