Professional Orthopedic and Sports Physical Therapy, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.

Practice address

3530 Post Rd
Suite 202
Southport, CT 06890-1169

Phone

(203) 307-4600

Fax

(203) 307-4601

NPI assigned

Apr 6, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1609230622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 POST RD",
            "address_2": "SUITE 202",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901169",
            "telephone_number": "203-307-4600",
            "fax_number": "203-307-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Perry, L.C.S.W.
• Joseph Anthony Piliero, DDS
• Beth Ageloff Posner, DMD
• Pro-Health Chiropractic, P.C.
• Professional Occupational & Physical Therapy, PLLC
• Professional Therapy Contracting Services of CT, LLC
• Progressive Care Medical Group of CT, PLLC
• Dennis A Ragoza, D.M.D.
• Ben Duncan Ramaley, M.D.
• Breanna Lyn Razdan, D.C.

• Physical Therapist in Southport, CT
• Providers in Southport, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.