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Individual

MR. BRIAN J MAGNANO

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
641 CLARK AVE, BRISTOL, CT 06010-4068
(866) 582-0389
(860) 582-3607
Mailing address
641 CLARK AVE, BRISTOL, CT 06010-4068
(866) 582-0389
(860) 582-3607

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007294
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08007294CT16
BLUE CROSS
CT
01
111199
HEALTHPARTNERS
01
2V5785
HEALTHNET
01
3697028
AETNA
CT
01
P354241
OXFORD
Enumeration date
12/27/2005
Last updated
07/08/2007
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