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Organization

CHESHIRE FITNESS ZONE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CRAIG M. GOLDSTEIN PT (OWNER)
(203) 250-9663
Entity
Organization

Contact information

Practice address
382 S MAIN ST, CHESHIRE, CT 06410-1379
(203) 250-9663
(203) 699-9641
Mailing address
382 S MAIN ST, CHESHIRE, CT 06410-1379
(203) 250-9663
(203) 699-9641

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
005678
CT
2251P0200X
Pediatric Physical Therapist
Primary
005678
CT
225XP0200X
Pediatric Occupational Therapist
002758
CT
235Z00000X
Speech-Language Pathologist
003550
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004209674
CT
01
0100901
AETNA ORTHONET
CT
01
0800005678CT01
BCBS-CRAIG GOLDSTEIN, PT
CT
01
080005678CT01
BCBS - PROVIDER ID
CT
01
100901
HEALTHNET ORTHONET - ID
CT
01
1257980
CIGNA
CT
01
12701
CIGNA - ORTHONET ID
CT
01
130002758CT01
BCBS
CT
01
2370736
AETNA
CT
01
2V8125
HEALTHNET - ID
CT
01
3672389002
CIGNA
CT
01
50CHESFITCT01
BCBS-CHESHIRE FITNESS ZONE, FACILITY
CT
01
61594157
MEDSPAN
CT
01
64-04292
UNITED HEALTHCARE ID
CT
01
660003550CT01
BCBS
CT
01
754954
CONNECTICARE
CT
01
9044356
AETNA
CT
01
9168247
AETNA
CT
01
A2646342
OXFORD HEALTHCARE ID
CT
Enumeration date
02/23/2007
Last updated
06/29/2020
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