Healthcare Provider Details

I. General information

NPI: 1336608892
Provider Name (Legal Business Name): ABIGAIL L BAYZATH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 PARK AVE
BRIDGEPORT CT
06604-1047
US

IV. Provider business mailing address

5151 PARK AVE # MC1011
FAIRFIELD CT
06825-1090
US

V. Phone/Fax

Practice location:
  • Phone: 203-416-3934
  • Fax:
Mailing address:
  • Phone: 609-351-9195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02110200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: