| Elizabeth Gross, PT | |
| 
					158 South Broad Street, Pawcatuck, CT 06379-1925  | |
| (860) 599-0819 | |
| (860) 599-0871 | 
| Full Name | Elizabeth Gross | 
|---|---|
| Gender | Female | 
| Speciality | Physical Therapist | 
| Location | 158 South Broad Street, Pawcatuck, Connecticut | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104881812 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225100000X | Physical Therapist | 004925 (Connecticut) | Primary | 
| Provider Name | Dynamic Physical Therapy Llc | 
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Provider Identifiers | NPI Number: 1861682296 PECOS PAC ID: 9436233715 Enrollment ID: O20230906002550  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Elizabeth Gross, PT 158 South Broad Street, Pawcatuck, CT 06379-1925 Ph: (860) 599-0819  | Elizabeth Gross, PT 158 South Broad Street, Pawcatuck, CT 06379-1925 Ph: (860) 599-0819  | 
Sarah E Bicknell, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 37 S Broad St Ste 12, Pawcatuck, CT 06379 Phone: 860-495-1919 Fax: 860-495-0130  | |
Mary Sue Agostini, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 158 South Broad Street, Dynamic Physical Therapy Llc, Pawcatuck, CT 06379 Phone: 860-599-0819 Fax: 860-599-0871  |