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Individual

JASON BENNETT MYERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
888 WHITE PLAINS RD, TRUMBULL, CT 06611-4552
(203) 268-2882
(203) 452-3097
Mailing address
11 PEQUOT CT, MONROE, CT 06468-1296
(732) 618-7010

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007907
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007907
LICENSE
CT
Enumeration date
08/31/2006
Last updated
01/29/2021
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