Healthcare Provider Details

I. General information

NPI: 1588999577
Provider Name (Legal Business Name): WHITNEYVILLE PHYSICAL THERAPY PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 WHITNEY AVE
HAMDEN CT
06517-1209
US

IV. Provider business mailing address

1952 WHITNEY AVE
HAMDEN CT
06517-1209
US

V. Phone/Fax

Practice location:
  • Phone: 203-848-1803
  • Fax: 203-848-1777
Mailing address:
  • Phone: 203-848-1803
  • Fax: 203-848-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARGARET CHUSTECKA
Title or Position: MD
Credential: MD
Phone: 203-848-1803