| 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 |