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

Table of content: (NPI 1285735308)

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)





Copyright © 2007-2024 www.npivalidator.com