| Alexander Geoffrey Russell, PT, DPT, CSCS | |
|
60 Market St Ste 130, Avon, CT 06001-4282 | |
| (860) 703-8505 | |
| Not Available |
| Full Name | Alexander Geoffrey Russell |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 60 Market St Ste 130, Avon, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750156956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 27263 (Massachusetts) | Secondary |
| 225100000X | Physical Therapist | 14282 (Connecticut) | Primary |
| Provider Name | Performance Rehabilitation Of Western New England Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1710919063 PECOS PAC ID: 7911979950 Enrollment ID: O20040810000712 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Geoffrey Russell, PT, DPT, CSCS 60 Market St Ste 130, Avon, CT 06001-4282 Ph: () - | Alexander Geoffrey Russell, PT, DPT, CSCS 60 Market St Ste 130, Avon, CT 06001-4282 Ph: (860) 703-8505 |
Jonathan Soderquist, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 44 Dale Rd, Suite 203, Avon, CT 06001 Phone: 860-674-1713 Fax: 860-674-1848 | |
Bernardine Lapaan, Physical Therapist Medicare: Medicare Enrolled Practice Location: 44 Dale Rd Ste 203, Avon, CT 06001 Phone: 860-674-1713 | |
Cynthia Langer, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 45 E Main St, Avon, CT 06001 Phone: 860-402-7743 | |
Thomas Kirsch, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 44 Dale Rd Ste 203, Avon, CT 06001 Phone: 860-674-1713 | |
Haley Wolfanger, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 55 Climax Rd Ste 120, Avon, CT 06001 Phone: 860-703-8505 | |
Mr. Bartlomiej Kolcz, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 44 Dale Rd Ste 203, Avon, CT 06001 Phone: 860-674-1713 | |
Keely Yarish, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 44 Dale Rd Ste 203, Avon, CT 06001 Phone: 860-674-1713 |