Individual
MR. MARC I ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
339 EASTERN ST, SUITE 317, NEW HAVEN, CT 06513
(203) 468-7002
(203) 468-7078
Mailing address
733 SOUTH MAIN ST, CHESHIRE, CT 06410
(203) 272-7368
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006225
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006225CT02
ANTHEM BCBS
CT
01
—
2467781
AETNA
—
Enumeration date
07/25/2006
Last updated
07/08/2007
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