Provider Demographics
NPI:1912289158
Name:NEW FAIRFIELD HEALTH AND INJURY CENTER PC
Entity Type:Organization
Organization Name:NEW FAIRFIELD HEALTH AND INJURY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CIATTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-546-7320
Mailing Address - Street 1:100 ROUTE 37
Mailing Address - Street 2:FAIRWOOD PROFESSIONAL BUILDING
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812
Mailing Address - Country:US
Mailing Address - Phone:203-546-7320
Mailing Address - Fax:203-546-7323
Practice Address - Street 1:100 ROUTE 37
Practice Address - Street 2:FAIRWOOD PROFESSIONAL BUILDING
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812
Practice Address - Country:US
Practice Address - Phone:203-546-7320
Practice Address - Fax:203-546-7323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTX010705208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty