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General NPI Number Information
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NPI Number | 1841461076
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Entity Type | Individual
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Provider Name | ALICIA BETH HIRSCHT PT
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Gender | Female
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Dates
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Enumeration Date | 03/15/2008
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 6 GREENWICH OFFICE PARK 40 VALLEY DRIVE
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City | GREENWICH
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State | CT
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Zip | 06831-5151
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Country | US
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Telephone | 203-869-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 6 GREENWICH OFFICE PARK 40 VALLEY DRIVE
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City | GREENWICH
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State | CT
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Zip | 06831-5151
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Country | US
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Telephone | 203-869-1145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 070013392
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License Number State | IL
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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 | 8280
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License Number State | CT
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