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Organization
SPORTSMED PT OF CONNECTICUT PLLC
Active
Organization
SPORTSMED PT OF CONNECTICUT PLLC
Active
Other names
SportsMed Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL AZAR RN, BSN (VP OF RCM)
(201) 857-0527
Entity
Organization
Contact information
Practice address
4775 MAIN ST, BRIDGEPORT, CT 06606-1877
(201) 345-5905
Mailing address
266 HARRISTOWN RD STE 304, GLEN ROCK, NJ 07452-3321
(201) 345-5905
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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