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General NPI Number Information
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NPI Number | 1760765200
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Entity Type | Organization
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Legal Business Name | PREMIER PHYSICAL THERAPY OF DARIEN INC
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 36 OLD KINGS HWY S SUITE 110
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City | DARIEN
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State | CT
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Zip | 06820-4552
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Country | US
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Telephone | 203-202-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 3RD AVE 5TH FL.
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City | NEW YORK
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State | NY
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Zip | 10028-2167
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Country | US
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Telephone | 212-861-2630
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARYANNE NOLAN
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Credential |
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Telephone | 212-861-2630
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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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