Formula for Performance & Rehab, LLC
Organization Active NPI Physical Therapist · Weston, CT
NPI 1992114508 · NPPES record last updated Aug 29, 2014
Key facts
- NPI
- 1992114508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- FORMULA FOR PERFORMANCE & REHAB, LLC
- Practice address
- 59 Valley Forge Rd
Weston, CT 06883-1912 - Phone
- (203) 227-6666
- NPI assigned
- Aug 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Nicholas Corwin
- Title
- Managing Director
- Phone
- (203) 247-2270
Practitioners 1
-
Kevin N Baldeo, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141218002392 | CT | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3779806963 |
Receives reassigned benefits from 1 practitioner Practice locations: Weston, CT; Norwalk, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
59 Valley Forge Rd
Weston, CT 06883-1912
Mailing address
59 Valley Forge Rd
Weston, CT 06883-1912
Phone (203) 227-6666
Other providers in Weston, CT
- Richard Ellis
- Judith R. Epstein
- Eve Applebaum, Psychotherapist
- Jacqueline Fidelman
- Kathleen B Fitzgerald
- Michele Anderson Friedman
- Ann Garvey
- Luke T Garvey
- Mark Goldenberg
- Katherine Ann Griffin
All providers in Weston, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.