Madyda, Crystal B.
Madyda, Crystal B. is an individual health care provider with primary practice located at 90 Grove St Suite # 106, Ridgefield CT 06877-4114. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Madyda, Crystal B. can be contacted via phone (203) 431-8471.Contact Information
Primary practice address
90 Grove St Suite # 106
Ridgefield CT 06877-4114
Phone: (203) 431-8471
Fax: (203) 438-9543
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 006220 | Connecticut |
Profile Details
| NPI number | 1568411452 |
|---|---|
| LBN Legal business name | Madyda, Crystal B. |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2006 |
| Last updated | Feb 3rd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568411452 | NPPES |
| Connecticut | Other | 080006220 | ANTHEM BC |
| Connecticut | MEDICAID | 004210150 | ANTHEM BC |
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