Provider Demographics
NPI:1063069029
Name:DTG GROUP LLC
Entity type:Organization
Organization Name:DTG GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-578-7225
Mailing Address - Street 1:92 BROOKSIDE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-1402
Mailing Address - Country:US
Mailing Address - Phone:203-578-7225
Mailing Address - Fax:
Practice Address - Street 1:92 BROOKSIDE RD STE 103
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-1402
Practice Address - Country:US
Practice Address - Phone:203-578-7225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty