Healthcare Provider Details

I. General information

NPI: 1609014893
Provider Name (Legal Business Name): CORE PHYSICAL THERAPY & SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 MAIN ST STE 303, 304
BRIDGEPORT CT
06606-4237
US

IV. Provider business mailing address

3180 MAIN ST STE 202, 204
BRIDGEPORT CT
06606-4237
US

V. Phone/Fax

Practice location:
  • Phone: 203-373-1593
  • Fax: 203-549-0899
Mailing address:
  • Phone: 203-373-1593
  • Fax: 203-549-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID TUNG
Title or Position: PRESIDENT
Credential: MD
Phone: 203-378-1593