Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 006053 | CT |
NPI | 1386861201 |
---|---|
Provider Name | Robert John Friedberg |
First Address | Simsbury, CT 06070-2923 |
Second Address | West Hartford, CT 06119-1324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |