Healthcare Provider Details

I. General information

NPI: 1144768847
Provider Name (Legal Business Name): PROFESSIONAL THERAPY CONTRACTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 DANBURY RD
WILTON CT
06897-4405
US

IV. Provider business mailing address

2142 UTOPIA PKWY
WHITESTONE NY
11357-4142
US

V. Phone/Fax

Practice location:
  • Phone: 203-307-4600
  • Fax: 203-307-4601
Mailing address:
  • Phone: 718-819-6805
  • Fax: 347-841-9109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN BRUSH
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 718-819-6805