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Individual
MR. PAUL ROBERT BERRY
Active
Individual
MR. PAUL ROBERT BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001915
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019501
AETNA ORTHONET
CT
01
—
041801
HEALTHNET
CT
01
—
0565313
AETNA
—
01
—
080001915CT02
ANTHEM BLUE CROSS &BLUE S
CT
01
—
0Q774710
EMPIRE BLUE CROSS BLUE SH
—
01
—
104823000
DOL FECA
—
01
—
19501
CIGNA ORTHONET
—
01
—
207806
WELLCARE
—
01
—
ZS968
OXFORD HEALTH PLANS
CT
Enumeration date
12/26/2005
Last updated
12/10/2009
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