Provider Demographics
NPI:1952117269
Name:GEM PHYSICAL THERAPY
Entity type:Organization
Organization Name:GEM PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:860-984-2113
Mailing Address - Street 1:1665 MAIN ST APT A
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2991
Mailing Address - Country:US
Mailing Address - Phone:860-984-2113
Mailing Address - Fax:
Practice Address - Street 1:1665 MAIN ST APT A
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2991
Practice Address - Country:US
Practice Address - Phone:860-984-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy