Alexandra Pires

Individual provider Active NPI Physical Therapy Assistant · Moodus, CT

NPI 1700569365 · NPPES record last updated Aug 10, 2023

Key facts

NPI
1700569365
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
001953 (CT)
Practice address
534 Town St
Moodus, CT 06469-1101
Phone
(860) 873-1455
Fax
(860) 873-2307
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001953CTMDNutritionist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001953 CT Yes

Addresses

Primary practice location

534 Town St
Moodus, CT 06469-1101

Mailing address

534 Town St
Moodus, CT 06469-1101
Phone (860) 873-1455

Other providers in Moodus, CT

All providers in Moodus, CT · Physical Therapy Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.