Healthcare Provider Details
I. General information
NPI: 1831594829
Provider Name (Legal Business Name): APEX PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2014
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 CROMWELL AVE STE Q
ROCKY HILL CT
06067-3013
US
IV. Provider business mailing address
825 CROMWELL AVE STE Q
ROCKY HILL CT
06067-3013
US
V. Phone/Fax
- Phone: 860-257-3779
- Fax: 860-257-3780
- Phone: 860-257-3779
- Fax: 860-257-3780
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 004389 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | 004389 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | 004389 |
| License Number State | CT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 004389 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
ANAND
KUMAR
BISHNOI
Title or Position: DIRECTOR/OWNER
Credential: DPT
Phone: 860-257-3779