Provider Demographics
NPI:1023760147
Name:BAYTIDE HEALTH
Entity type:Organization
Organization Name:BAYTIDE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L, CHT
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIPSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-510-3579
Mailing Address - Street 1:225 BOSTON POST ROAD
Mailing Address - Street 2:PO BOX 386
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32 LOVERS LN
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1500
Practice Address - Country:US
Practice Address - Phone:860-510-3579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE- CASH BASED