Healthcare Provider Details

I. General information

NPI: 1205025798
Provider Name (Legal Business Name): HEALTH & REHABILITATION PARTNERSHIP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 WEST AVE
NORWALK CT
06850-3302
US

IV. Provider business mailing address

698 WEST AVE
NORWALK CT
06850-3302
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-9903
  • Fax: 203-354-2983
Mailing address:
  • Phone: 203-852-9903
  • Fax: 203-354-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCT
# 6
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateCT

VIII. Authorized Official

Name: MR. RALPH A ANTONACCI JR.
Title or Position: MANAGING PARTNER
Credential: MSPT, LAT, ATC, CSCS
Phone: 203-852-9903