Healthcare Provider Details

I. General information

NPI: 1689653388
Provider Name (Legal Business Name): CYNTHIA BAHR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 SAND PIT RD
DANBURY CT
06810
US

IV. Provider business mailing address

69 SAND PIT RD
DANBURY CT
06810-4004
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-5631
  • Fax: 203-207-3194
Mailing address:
  • Phone: 203-748-5631
  • Fax: 203-207-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number003322
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: