1285735308 NPI number — NEW ENGLAND PHYSICAL THERAPY SERVICES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285735308 NPI number — NEW ENGLAND PHYSICAL THERAPY SERVICES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND PHYSICAL THERAPY SERVICES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEPTS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285735308
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 VILLAGE WALK
Provider Second Line Business Mailing Address:
PMB 274
Provider Business Mailing Address City Name:
GUILFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06437-2762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-453-5712
Provider Business Mailing Address Fax Number:
203-488-1029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HAMILTON RD
Provider Second Line Business Practice Location Address:
MEDICAL DEPT., 1-1-BC38
Provider Business Practice Location Address City Name:
WINDSOR LOCKS
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06096-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-654-2503
Provider Business Practice Location Address Fax Number:
860-654-5816
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUTEAU
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-453-5712

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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