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Individual

PETER ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC, CSCS

Contact information

Practice address
2 RIVERVIEW DR, DANBURY, CT 06810
(203) 797-1500
(203) 791-0495
Mailing address
2 RIVERVIEW DR, DANBURY, CT 06810-6268
(203) 797-1500
(203) 791-0495

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
NO LICENSES YET
CT
363A00000X
Physician Assistant
002645
CT
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
089902436
NATABOC CERT. NUMBER
CT
01
999608
NSCA CSCS CERT. NUMBER
CT
Enumeration date
03/25/2006
Last updated
05/23/2018
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