Healthcare Provider Details

I. General information

NPI: 1104795871
Provider Name (Legal Business Name): PT AND PILATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 REALTY DR STE 100
CHESHIRE CT
06410-4600
US

IV. Provider business mailing address

121 CASTLEWOOD DR
BERLIN CT
06037-2911
US

V. Phone/Fax

Practice location:
  • Phone: 860-712-1685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA HACKETT
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 860-712-1685