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DIANE K LONG PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1174595953

Individual Registrant:
 DIANE K LONG PT
Gender: F

Location and contact information for practice:
6 GREENWICH OFFICE PARK  GREENWICH, CT 06831-5151 US
Tel: 203-869-1145  Fax: 203-629-7606

Contact information for business:
6 GREENWICH OFFICE PARK  GREENWICH, CT 06831-5151 US
Tel: 203-869-1145  Fax: 203-629-7606

Registration Information:
NPI: 1174595953
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CT003812

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AETNA3120763CT01
ANTHEM BCBS080003812CT04CT01




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