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NPI Code Detail

MEDICARE: MARY FRANGUS PT

MEDICARE: MARY FRANGUS PT
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
1225100000XPhysical Therapist6723CT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D100263001OTHERCTMEDICARE GROUP PTAN

General Provider Information

NPI Number : 1881145530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FRANGUS PT
Provider Business Mailing Address
First Line : 27 GOVERNOR ST
Second Line :
City : RIDGEFIELD
State : CT
Zip : 06877-4657
Country : US
Telephone Number : 203-438-5555
Fax Number : 203-431-6533
Provider Business Practice Location Address
First Line : 27 GOVERNOR ST
Second Line :
City : RIDGEFIELD
State : CT
Zip : 06877-4657
Country : US
Telephone Number : 203-438-5555
Fax Number : 203-431-6533
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2016
Last Update Date : 10/18/2016

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Directions to “ MARY FRANGUS PT” Practice Location

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