Provider Demographics
NPI:1255598660
Name:SILVANA FIX, LLC
Entity type:Organization
Organization Name:SILVANA FIX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RADOCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-255-0080
Mailing Address - Street 1:79 S BENSON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6230
Mailing Address - Country:US
Mailing Address - Phone:203-255-0080
Mailing Address - Fax:203-255-0018
Practice Address - Street 1:79 S BENSON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6230
Practice Address - Country:US
Practice Address - Phone:203-255-0080
Practice Address - Fax:203-255-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03420Medicare PIN