Integrated Physical Therapy and Pain Management, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

007561 Issued in CT

Legal business name

INTEGRATED PHYSICAL THERAPY AND PAIN MANAGEMENT, LLC

Practice address

67 Holly Hill LN Ste 101
Greenwich, CT 06830-6072

Phone

(203) 252-6989

NPI assigned

Jul 19, 2014

Organization subpart

No

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

Authorized official

Name

Djoana Clara Herrera Bakani, RPT

Title

Physical Therapist

Phone

(203) 252-6989

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1932516119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BYRAM SHORE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306926",
            "telephone_number": "203-252-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 HOLLY HILL LN STE 101",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306072",
            "telephone_number": "203-252-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PHYSICAL THERAPY AND PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-19",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "BAKANI",
        "authorized_official_first_name": "DJOANA CLARA",
        "authorized_official_middle_name": "HERRERA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "203-252-6989",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "007561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "D400194066",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Greenwich, CT
• Providers in Greenwich, 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 Nov 28, 2022; 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.