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Organization
OMNI PHYSICAL & AQUATIC THERAPY CENTER, INC
Active
Organization
OMNI PHYSICAL & AQUATIC THERAPY CENTER, INC
Active
Other names
Omni Medical
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA ANN MAHONEY-RANDALL (BILLING MANAGER)
(203) 877-0112
Entity
Organization
Contact information
Practice address
8 RESEARCH PKWY, WALLINGFORD, CT 06492-1929
(203) 294-1998
(203) 294-1189
Mailing address
8 RESEARCH PKWY, WALLINGFORD, CT 06492-1929
(203) 294-1998
(203) 294-1189
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
CT
111NR0400X
Rehabilitation Chiropractor
—
CT
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
225100000X
Physical Therapist
—
CT
2251G0304X
Geriatric Physical Therapist
—
CT
2251X0800X
Orthopedic Physical Therapist
—
CT
225X00000X
Occupational Therapist
—
CT
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004173184
BLUE CARE FAMILY PLAN
CT
05
—
004173184
—
CT
05
—
004255271
—
CT
01
—
0V1691
HEALTHNET
CT
01
—
183158
FIRST CHOICE
CT
01
—
552470
AETNA
CT
01
—
6404254
UNITED HEALTHCARE
CT
01
—
712712
CONNECTICARE
CT
01
—
A667399
OXFORD
CT
Enumeration date
02/20/2007
Last updated
07/21/2022
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