Elizabeth Gross, PT | |
158 South Broad Street, Pawcatuck, CT 06379-1925 | |
(860) 599-0819 | |
(860) 599-0871 |
Full Name | Elizabeth Gross |
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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 |
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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 |