Provider Demographics
NPI:1447453501
Name:AMFIT PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:AMFIT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ACOCELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGING DIRECTOR
Authorized Official - Phone:203-869-5546
Mailing Address - Street 1:469 W PUTNAM AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6060
Mailing Address - Country:US
Mailing Address - Phone:203-869-5546
Mailing Address - Fax:203-629-4836
Practice Address - Street 1:469 W PUTNAM AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6060
Practice Address - Country:US
Practice Address - Phone:203-869-5546
Practice Address - Fax:203-629-4836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9794769000273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02553Medicare ID - Type Unspecified