MEDICARE: LJH ENTERPRISES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1639540941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LJH ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	126 MONROE TPKE
Second Line	:	2ND FLOOR
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 MONROE TPKE
Second Line	:	2ND FLOOR
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1300
Country	:	US
Telephone Number	:	860-930-4590
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAURENCE J HILL
Credential	:
Telephone Number	:	860-930-4590

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	10/13/2015

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Directions to “LJH ENTERPRISES LLC ” Practice Location

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