Individual ProviderNicholas RezendesPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address78 Staffordshire Commons Dr, Wallingford, CT 06492-1757(860) 287-2018PECOS EnrollmentBased on the most recent information from CMS, provider Nicholas Rezendes does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1609149194Provider TypeIndividualFull NameRezendes, NicholasCredentialD.P.T.GenderMaleSole ProprietorYesEnumeration Date2/15/2012Last Updated2/15/2012Contact InformationPractice LocationPractice Address78 Staffordshire Commons Dr, Wallingford, CT 06492-1757Phone(860) 287-2018FaxUnlisted FaxMailing LocationMailing Address78 Staffordshire Commons Dr, Wallingford, CT 06492-1757Phone(860) 287-2018FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1214503Texas