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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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