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General NPI Number Information
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NPI Number | 1801909114
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Entity Type | Organization
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Legal Business Name | PHASE ONE PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 385 MAIN ST S STE 212
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City | SOUTHBURY
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State | CT
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Zip | 06488-4156
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Country | US
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Telephone | 203-262-4603
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Fax | 203-262-4603
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Provider Business Mailing Address
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Address Line | PO BOX 1056
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City | SOUTHBURY
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State | CT
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Zip | 06488-4156
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Country | US
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Telephone | 203-264-7551
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Fax | 203-264-7551
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS JAMES CARL ABROMAITIS
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Credential | RPT
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Telephone | 203-264-7551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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