Provider Demographics
NPI:1841324316
Name:AQUACISE & PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:AQUACISE & PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:203-882-0000
Mailing Address - Street 1:167 CHERRY ST
Mailing Address - Street 2:#415
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3466
Mailing Address - Country:US
Mailing Address - Phone:203-882-0000
Mailing Address - Fax:203-445-9104
Practice Address - Street 1:167 CHERRY ST
Practice Address - Street 2:#415
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3466
Practice Address - Country:US
Practice Address - Phone:203-882-0000
Practice Address - Fax:203-445-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty