Healthcare Provider Details

I. General information

NPI: 1346144474
Provider Name (Legal Business Name): RISP PHYSICAL THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 HARTSWOOD RD
STAMFORD CT
06905-2211
US

IV. Provider business mailing address

133 HARTSWOOD RD
STAMFORD CT
06905-2211
US

V. Phone/Fax

Practice location:
  • Phone: 203-715-5907
  • Fax:
Mailing address:
  • Phone: 203-715-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SUDHA KOTHA
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 203-715-5907