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Individual
MRS. ELIZABETH L BRONNER
Active
Individual
MRS. ELIZABETH L BRONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
19529
MA
225100000X
Physical Therapist
Primary
7603
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010901
ORTHONET/HEALTHNET PROV
CT
01
—
076572
MEDICARE GROUP ID
CT
01
—
7687681
AETNA PROVIDER ID
CT
01
—
XV2528
HEALTHNET PROVIDER ID
CT
Enumeration date
07/18/2006
Last updated
11/06/2013
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