Organization
PHYSICAL THERAPY OF SOUTHERN CONNECTICUT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA MAUDE RPT (PRESIDENT)
(203) 735-8336
Entity
Organization
Contact information
Practice address
111 NEW HAVEN AVE, DERBY, CT 06418-2197
(203) 735-8336
(203) 735-3704
Mailing address
111 NEW HAVEN AVE, DERBY, CT 06418-2197
(203) 735-8336
(203) 735-3704
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004398203
—
CT
01
—
50PTSOUTHPT01
ANTHEM BLUE CROSS
CT
01
—
ANC1153
OXFORD HEALTH PLANS
CT
01
—
OV1301
HEALTHNET
CT
Enumeration date
12/18/2006
Last updated
07/21/2022
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