Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MCKIERNAN PHYSICAL THERAPY LLC
Active
Organization
MCKIERNAN PHYSICAL THERAPY LLC
Active
Other names
Allied Health & Wellness Centers
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD G MCKIERNAN RPT (OWNER)
(203) 268-5801
Entity
Organization
Contact information
Practice address
115 TECHNOLOGY DR, STE A-200, TRUMBULL, CT 06611-6337
(203) 268-5801
(203) 452-3688
Mailing address
115 TECHNOLOGY DR, STE A-200, TRUMBULL, CT 06611-6337
(203) 268-5801
(203) 452-3688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004917
CT
332BC3200X
Customized Equipment (DME)
004917
CT
335E00000X
Prosthetic/Orthotic Supplier
004917
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080004917CT04
ANTHEM BCBS PIN
CT
01
—
2V5288
HEALTH NET PIN
CT
01
—
3515548
CIGNA PIN
CT
01
—
3917515
AETNA PIN
CT
01
—
A2983697
OXFORD PIN
CT
Enumeration date
08/31/2006
Last updated
01/30/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers