Eclectic Physical Therapy LLC
NPI 1730421397ActiveOrganization· Clinic/Center· Bridgeport, CT
Clinic/Center in Bridgeport, Connecticut, registered in NPPES in March 2013. The authorized official on file is Jennifer Lee Iannucci, PT, Physical Therapist, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1730421397 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 21, 2013 |
| Last updated in NPPES | May 16, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 005735 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (CT) |
|---|
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