| Core Physical Therapy & Sports Medicine Pc | |
|
3180 Main St, Ste 303, 304, Bridgeport, CT 06606-4237 | |
| (203) 373-1593 | |
| (203) 549-0899 |
| Full Name | Core Physical Therapy & Sports Medicine Pc |
|---|---|
| Type | Facility |
| Speciality | Physical Medicine & Rehabilitation - Sports Medicine |
| Location | 3180 Main St, Bridgeport, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609014893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Larry Seth Lieberman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619125663 PECOS PAC ID: 4789652561 Enrollment ID: I20040920000740 |
| Provider Name | David Lee Tung |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1972799799 PECOS PAC ID: 0749343408 Enrollment ID: I20170706001508 |
| Provider Name | Kurt Sierer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063939122 PECOS PAC ID: 3274808605 Enrollment ID: I20171010002929 |
| Provider Name | Shiva Gundavaram |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992121883 PECOS PAC ID: 1759657612 Enrollment ID: I20171019002427 |
| Provider Name | Matthew Reuter |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1487953014 PECOS PAC ID: 4183934136 Enrollment ID: I20180823002729 |
| Provider Name | Tenzin Yangzom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912610676 PECOS PAC ID: 3072987502 Enrollment ID: I20230323000280 |
| Mailing Address | Practice Location Address |
|---|---|
| Core Physical Therapy & Sports Medicine Pc 3180 Main St, Ste 202, 204, Bridgeport, CT 06606-4237 Ph: (203) 373-1593 | Core Physical Therapy & Sports Medicine Pc 3180 Main St, Ste 303, 304, Bridgeport, CT 06606-4237 Ph: (203) 373-1593 |