Organization
VILLAGE STREET PHYSICAL THERAPY AND SPORTS MEDICINE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL DUFRESNE (OWNER)
(203) 562-8140
Entity
Organization
Contact information
Practice address
12 VILLAGE ST, SUITE 10, NORTH HAVEN, CT 06473-3828
(203) 562-8140
Mailing address
12 VILLAGE ST, SUITE 10, NORTH HAVEN, CT 06473-3828
(203) 562-8140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080002017CT01
BCBS
CT
01
—
183259
WELLCARE
CT
01
—
7614976004
CIGNA
CT
01
—
897715
AETNA
CT
01
—
A531345
OXFORD
CT
01
—
OV1735
HEALTHNET
CT
Enumeration date
11/26/2007
Last updated
10/13/2011
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