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General NPI Number Information
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NPI Number | 1487749404
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Entity Type | Organization
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Legal Business Name | GLOBAL PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/04/2014
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Provider Practice Location Address
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Address Line | 580 FARMINGTON AVE SUITE #101
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City | HARTFORD
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State | CT
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Zip | 06105-3050
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Country | US
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Telephone | 860-233-2222
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Fax | 860-570-0666
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Provider Business Mailing Address
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Address Line | 580 FARMINGTON AVE SUITE #101
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City | HARTFORD
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State | CT
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Zip | 06105-3050
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Country | US
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Telephone | 860-233-2222
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Fax | 860-570-0666
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARINA SASONOV
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Credential | PHYSICAL THERAPIST
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Telephone | 860-233-2222
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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 | 004400
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004862
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License Number State | CT
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