DYNAMIC EDGE PHYSIOTHERAPY, LLC (NPI# 1699125187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699125187 |
| Entity Type | Organization |
| Organization Name | DYNAMIC EDGE PHYSIOTHERAPY, LLC |
| Practice Address |
396 Danbury Rd Unit 5 Wilton CT 06897-2024 |
| Practice Telephone | 2039783343 |
| Mailing Telephone | 2039783343 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |
| Authorized Official Name | PATRICK BUCKLEY (MEMBER) |
| Authorized Official Telephone | 2039783343 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
0009132 | CT | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | DYNAMIC EDGE PHYSIOTHERAPY, LLC | 396 Danbury Rd, Wilton, CT 06897 |
| Street Address |
396 DANBURY RD UNIT 5 |
| City | WILTON |
| State | CT |
| Zip Code | 06897-2024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747968 | Jeremiah James Lewis | Internal Medicine | 396 Danbury Rd, Wilton, CT 06897-2024 | 2005-08-19 |
| 1649778580 | Mario Pasquel | Physical Therapist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2018-01-25 |
| 1437432721 | Samuel Hopkins | Physical Therapist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2011-09-22 |
| 1972881050 | Thomas Xu | Internal Medicine | 396 Danbury Rd, Wilton, CT 06897-2024 | 2011-07-24 |
| 1528356193 | Lisa Illinger | Physical Therapist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2011-07-18 |
| 1801187661 | Patrick Kim Buckley | Physical Therapist | 396 Danbury Rd, Unit 5, Wilton, CT 06897-2024 | 2011-04-28 |
| 1457669343 | Amanda Kaslowitz | Physical Therapist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2010-09-14 |
| 1760665426 | Wilton Ob/gyn, LLC | Specialist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2007-12-17 |
| 1093807695 | Ruben D Kearney | Physical Therapist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2006-09-29 |
| 1083633119 | Geraldine M. Kearney | Specialist | 396 Danbury Rd, Wilton, CT 06897-2024 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083191878 | Cefaly Us, Inc | Durable Medical Equipment & Medical Supplies | 187 Danbury Rd, 3rd Fl Riverside, Wilton, CT 06897 | 2018-07-24 |
| 1154747798 | Llonel Laxamana De Dios | Physical Therapist | 44 Old Ridgefield, Road Suite 213 Fox Rehab Connecticut Regional Office, Wilton, CT 06897 | 2014-03-06 |
| 1679911937 | Colleen Nee | Social Worker | 29 School St (route 107/redding Rd), Wilton, CT 06897 | 2013-06-10 |
| 1104123397 | Xin Wen Shi | Physical Therapist | 64 Danbury Road, Wilton, CT 06897 | 2011-02-24 |
| 1942434428 | Wilton Retirement Housing, LLC | Assisted Living Facility | 435 Danbury Rd., Wilton, CT 06897 | 2009-05-12 |
| 1891965257 | Ronald E. Ponchak, Pt, PC | Clinic/Center | 1 Danbury Road, Wilton, CT 06897 | 2008-03-01 |
| 1649478199 | Mary Steinowitz | Physical Therapist | 345 Belden Hill Road, Wilton, CT 06897 | 2007-07-06 |
| 1871708503 | Robin H Canter | Social Worker | 237 Danbury Road, Stillpoint Counseling, LLC, Wilton, CT 06897 | 2007-05-14 |
| 1073727541 | Elizabeth Rene Sirois | Occupational Therapy Assistant | 63 Danbury Road, Wilton, CT 06897 | 2007-05-10 |
| 1013132877 | Moore Center for Rehabilitation of Wilton, LLC | Physical Therapist | 37 Danbury Road, Wilton, CT 06897 | 2007-04-16 |
| Find all providers in zip 06897 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891965257 | Ronald E. Ponchak, Pt, PC | Clinic/Center | 1 Danbury Road, Wilton, CT 06897 | 2008-03-01 |
| 1336225036 | Wilton Physical Therapy, LLC | Clinic/Center | 23 Hubbard Rd, Wilton, CT 06897-3045 | 2006-10-27 |
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|---|---|---|---|---|
| 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 |
| 1396209029 | My Pain Guy LLC | Clinic/Center | 50 Quality St Unit 110615, Trumbull, CT 06611-7725 | 2019-01-28 |
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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.