Mystic Physical Therapy Associates PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MYSTIC PHYSICAL THERAPY ASSOCIATES PC

Practice address

100 Fort Hill Rd
Groton, CT 06340

Phone

(860) 445-9433

Fax

(860) 445-8802

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Lazarus Suren Donabedian

Title

Director Managing

Phone

(860) 966-7226

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Richard M Montmeny

  • Physical Therapist
  • Chapel Hill, NC
  • NPI 1003824756
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811955503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FORT HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-9433",
            "fax_number": "860-445-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FORT HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-9433",
            "fax_number": "860-445-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC PHYSICAL THERAPY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONABEDIAN",
        "authorized_official_first_name": "LAZARUS",
        "authorized_official_middle_name": "SUREN",
        "authorized_official_title_or_position": "DIRECTOR MANAGING",
        "authorized_official_telephone_number": "860-966-7226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Scott Mulder
• Vinu Sharad Murdande
• William Don Murphy III, IDC
• Megan Murray
• Mvca
• Mystic River Therapy LLC
• Michael Napolitano
• Pamela Nardella
• Daniel Joseph Nasser, DMD
• National Vision, Inc.

• Physical Therapy Clinic/Center in Groton, CT
• Providers in Groton, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.