1609072701 NPI number — WILLEM VERWEIJ PHYSICAL THERAPY, LLC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609072701 NPI number — WILLEM VERWEIJ PHYSICAL THERAPY, LLC

Employer Identification Number (EIN):

Provider Organization Name:

WILLEM VERWEIJ PHYSICAL THERAPY, LLC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

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:

1609072701

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

02/16/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

306 N. MAIN STREET UNIT 5

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROCHESTER

Provider Business Mailing Address State Name:

NH

Provider Business Mailing Address Postal Code:

03867-4353

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

603-335-4700

Provider Business Mailing Address Fax Number:

603-335-4704

Provider First Line Business Practice Location Address:

306 N. MAIN STREET UNIT 5

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ROCHESTER

Provider Business Practice Location Address State Name:

NH

Provider Business Practice Location Address Postal Code:

03867-4353

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

603-335-4700

Provider Business Practice Location Address Fax Number:

603-335-4704

Provider Enumeration Date:

06/25/2007

Authorized Official Last Name:

VERWEIJ

Authorized Official First Name:

WILLEM

Authorized Official Middle Name:

Authorized Official Title or Position:

OWNER/PHYSICAL THERAPIST

Authorized Official Telephone Number:

603-335-4700

• Taxonomy code: 225100000X , with the licence number:  1677 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 225100000X , with the licence number: 1661 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 08Y009941NH01 . This is a "ANTHEM FOR JULIE CURRIER" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 1225005317 . This is a "NPI FOR JULIE CURRIER PT" identifier . This identifiers is of the category "OTHER".
• Identifier: 30394075 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
• Identifier: 3434257 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 08Y005532NH01 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
• Identifier: 002867941 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1152330 . This is a "AETNA FOR JULIE CURRIER" identifier . This identifiers is of the category "OTHER".
• Identifier: AA11011 . This is a "HARVARD PILGRIM HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 0128756 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 1801784201 . This is a "NPI FOR WILLEM VERWEIJ PT" identifier . This identifiers is of the category "OTHER".
• Identifier: 30392805 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
• Identifier: 205224400 . This is a "US DOL WORKERS COMP" identifier . This identifiers is of the category "OTHER".