Healthcare Provider Details

I. General information

NPI: 1184082257
Provider Name (Legal Business Name): SOKOLSKI PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 DEMING ST MAIN OFFICE
MANCHESTER CT
06042-1778
US

IV. Provider business mailing address

46 LEE LN
TOLLAND CT
06084-3948
US

V. Phone/Fax

Practice location:
  • Phone: 860-713-3325
  • Fax: 860-432-0815
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number007873
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number008076
License Number StateCT

VIII. Authorized Official

Name: REBECCA SOKOLSKI
Title or Position: MANAGER
Credential: PT
Phone: 631-379-7684