Healthcare Provider Details

I. General information

NPI: 1316907561
Provider Name (Legal Business Name): PAUL EDMUND HIGGINS MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BLOOMFIELD AVE HEALTH SERVICE OFFICE
WEST HARTFORD CT
06117-1545
US

IV. Provider business mailing address

37 ARMSTRONG RD
ENFIELD CT
06082-2731
US

V. Phone/Fax

Practice location:
  • Phone: 860-768-5335
  • Fax: 860-768-7892
Mailing address:
  • Phone: 860-749-5747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6552
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number6552
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number6552
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: