NPIMap

Organization Active NPI

North Street Physical Medicine and Rehabilitation, PC

  • Physical Medicine & Rehabilitation Physician
  • Danbury, CT
National Provider Identifier
1730320474
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
043130 Issued in CT
Legal business name
NORTH STREET PHYSICAL MEDICINE AND REHABILITATION, PC
Practice address
1 Padanaram Rd
Danbury, CT 06811-4836
Phone
(203) 312-0210
Fax
(203) 312-0512
NPI assigned
Mar 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Authorized official

Name
Dr. Richard C Koffler, MDNPI 1467557264
Title
Owner
Phone
(203) 312-0210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 043130 CT Primary

Addresses

Primary practice location

1 Padanaram Rd
Danbury, CT 06811-4836

Mailing address

1 Padanaram Rd
Danbury, CT 06811-4836
Phone (203) 312-0210

National Provider Directory

National Provider Directory

Locations

100 State Route 37
New Fairfield, CT 06812
Phone (203) 312-0210

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303084800000",
    "number": "1730320474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PADANARAM RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114836",
            "telephone_number": "203-312-0210",
            "fax_number": "203-312-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PADANARAM RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114836",
            "telephone_number": "203-312-0210",
            "fax_number": "203-312-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STREET PHYSICAL MEDICINE AND REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2011-04-18",
        "status": "A",
        "authorized_official_last_name": "KOFFLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-312-0210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "043130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.