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RAYMOND A SHAW PT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1194732628
Individual Registrant: RAYMOND A SHAW PT
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
14 JONES HOLLOW RD STE 7 MARLBOROUGH, CT 06447-1448 US
Tel: 860-295-8188 Fax: 860-295-8976
Tel: 860-295-8188 Fax: 860-295-8976
Contact information for business:
14 JONES HOLLOW RD STE 7 MARLBOROUGH, CT 06447-1448 US
Tel: 860-295-8188 Fax: 860-295-8976
Tel: 860-295-8188 Fax: 860-295-8976
Registration Information:
NPI: 1194732628
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | CT | 3673 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BLUE CROSS BLUE SHEILD | 080003673CT04 | CT | 01 |
| 004111671 | CT | 05 |
