Healthcare Provider Details

I. General information

NPI: 1225943673
Provider Name (Legal Business Name): NOAH TEDESCHI DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S BROAD ST UNIT A
MERIDEN CT
06450
US

IV. Provider business mailing address

116 DANBURY RD STE 5
NEW MILFORD CT
06776-3442
US

V. Phone/Fax

Practice location:
  • Phone: 203-238-1334
  • Fax: 203-238-1351
Mailing address:
  • Phone: 203-238-1334
  • Fax: 203-238-1351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15577
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: