NORTHEAST SPINE & REHAB., LLC (NPI# 1891733457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891733457 |
| Entity Type | Organization |
| Organization Name | NORTHEAST SPINE & REHAB., LLC |
| Other Organization Name | NORTHEAST PHYSICAL THERAPY |
| Practice Address |
5520 Park Ave Suite 208 Trumbull CT 06611-3463 |
| Practice Telephone | 2033681192 |
| Practice Fax Number | 2033710358 |
| Mailing Telephone | 2033681192 |
| Mailing Fax Number | 2033710358 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-11-27 |
| Authorized Official Name | MR. RONELL RONLEY OWENS (OFFICIAL) |
| Authorized Official Telephone | 2033681192 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Northeast Physical Therapy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | NORTHEAST SPINE & REHAB SPINAL DECOMPRESSION, PHYSICAL THERAPY AND CHIROPRACTIC, LLC | 2542 Wantagh Avenue, Wantagh, Ny 11793 |
| Street Address |
5520 PARK AVE SUITE 208 |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487652665 | David H Witt | Internal Medicine | 5520 Park Ave, Ste 203, Trumbull, CT 06611-3463 | 2005-07-12 |
| 1053947465 | Hyungbok H Jeong | Nurse Practitioner | 5520 Park Ave, Trumbull, CT 06611-3463 | 2020-03-17 |
| 1902375835 | Laura Elizabeth Morris | Physician Assistant | 5520 Park Ave, Trumbull, CT 06611-3463 | 2018-11-20 |
| 1629581053 | Sophie Jaffe | Social Worker | 5520 Park Ave, Trumbull, CT 06611-3463 | 2017-11-07 |
| 1154834786 | Jordan Marcou | Physician Assistant | 5520 Park Ave, Trumbull, CT 06611 | 2017-11-06 |
| 1013439769 | Alexis Grace Shaub | Physician Assistant | 5520 Park Ave, Trumbull, CT 06611-3463 | 2017-07-14 |
| 1902346224 | Catherine Wei | Internal Medicine | 5520 Park Ave, Trumbull, CT 06611-3463 | 2017-03-06 |
| 1649725656 | Jenna Addison | Registered Nurse | 5520 Park Ave, Trumbull, CT 06611-3463 | 2016-08-19 |
| 1447519582 | Jill Cooper Kenney | Naturopath | 5520 Park Ave, Trumbull, CT 06611-3463 | 2012-05-10 |
| 1457619660 | Pain & Spine Specialists of Connecticut LLC | Specialist | 5520 Park Ave, 303, Trumbull, CT 06611-3463 | 2012-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073153326 | Justin Elijah Brantley | Physical Therapist | 888 White Plains Road Suite 209, Trumbull, CT 06611 | 2020-01-14 |
| 1184135733 | Stephen Graham | Speech-Language Pathologist | 126 Monroe Turnpike Suite #210, Trumbull, CT 06611 | 2017-10-22 |
| 1891214458 | Rachel Lopes | Social Worker | 132 Monroe Turnpike, 3rd Floor Suite 1, Trumbull, CT 06611 | 2017-09-14 |
| 1588193981 | James Geisler | Counselor | 23 Wilmot Ave., Trumbull, CT 06611 | 2017-06-08 |
| 1215463807 | Rodrigo Fernandez | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Avenue., Bridgeport Hospital Womens Health Care Center., Bridgeport, CT 06611 | 2017-05-03 |
| 1285087650 | Trumbull Pharmacy LLC | Pharmacy | 10 Broadway Road, Bldg B, Unit B, Trumbull, CT 06611 | 2016-07-20 |
| 1063897601 | Camilla Marie Schnaitmann | Social Worker | 132 Monroe Turnpike, Trumbull, CT 06611 | 2015-07-24 |
| 1194107318 | Alison R Kudish | Dentist | 160 Hawley Ln Ste 101, Trumbull, CT 06611 | 2015-06-24 |
| 1639456783 | Sagar Makanji | Pharmacist | 5065 Main Street, Ste Target, Target Pharmacy, Store 2361, Trumbull, CT 06611 | 2011-11-03 |
| 1639485956 | Beata Everett | Social Worker | 42 Craig Lane, Trumbull, CT 06611 | 2010-08-24 |
| Find all providers in zip 06611 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396209029 | My Pain Guy LLC | Clinic/Center | 50 Quality St Unit 110615, Trumbull, CT 06611-7725 | 2019-01-28 |
| 1881239358 | Healing Bridge Physical Therapy, LLC | Clinic/Center | 6527 Main St, Trumbull, CT 06611-1385 | 2019-11-08 |
| 1245776137 | Choice Manual Therapy LLC | Clinic/Center | 6527 Main St, Trumbull, CT 06611-1385 | 2017-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070827 | Hometown Health, LLC | Clinic/Center | 54 Hazard Ave # 161, Enfield, CT 06082-3845 | 2020-10-10 |
| 1811502867 | Zion Pt Ct PC | Clinic/Center | 1555 Post Road East, Inside Sherpa, Westport, CT 06880 | 2020-09-15 |
| 1053920439 | Oss Sports Physical Therapy | Clinic/Center | 500 Newfield Ave Ste 11, Stamford, CT 06905-3745 | 2020-07-30 |
| 1558983403 | Centrality Physical Therapy & Wellness, PC | Clinic/Center | 705 Boston Post Rd Ste 1b, Guilford, CT 06437-2733 | 2020-05-14 |
| 1639703622 | Dr Yoon Physical Therapy Inc | Clinic/Center | 609 Farmington Ave Ste Ll2, Hartford, CT 06105-3081 | 2020-02-27 |
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1609413491 | Beyond Physical Therapy LLC | Clinic/Center | 120 Steele Rd, Bristol, CT 06010-5672 | 2019-11-29 |
| 1588214381 | Good Physio Clinic Inc | Clinic/Center | 701 Cottage Grove Rd Ste 110, Bloomfield, CT 06002-3080 | 2019-09-13 |
| 1972169241 | Align Health LLC | Clinic/Center | 133 Columbia Blvd, Waterbury, CT 06710-1706 | 2019-05-13 |
| 1073004024 | Ridgefield Sensory Clinic LLC | Clinic/Center | 79 Danbury Rd Ste A1, Ridgefield, CT 06877-4023 | 2018-05-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.