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General NPI Number Information
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NPI Number | 1366313330
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Entity Type | Organization
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Legal Business Name | SOUTHBURY PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 100 MAIN ST N UNIT 205
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City | SOUTHBURY
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State | CT
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Zip | 06488-3842
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Country | US
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Telephone | 603-303-2390
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Fax | 603-580-3318
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Provider Business Mailing Address
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Address Line | 352 COBBLER LN
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City | SOUTHBURY
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State | CT
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Zip | 06488-4641
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Country | US
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Telephone | 516-361-0148
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Fax | 603-589-5075
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY SCHILLER
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Credential | DPT
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Telephone | 516-361-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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