Provider Demographics
NPI:1831241926
Name:TEMPLE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:TEMPLE HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-407-3576
Mailing Address - Street 1:230 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3224
Mailing Address - Country:US
Mailing Address - Phone:203-498-5980
Mailing Address - Fax:203-498-5999
Practice Address - Street 1:230 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3224
Practice Address - Country:US
Practice Address - Phone:203-498-5980
Practice Address - Fax:203-498-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT076512Medicare PIN
CT076512Medicare Oscar/Certification
CTC02525Medicare PIN