Brian Roach
Physical Therapy Assistant in New Haven, CT. Individual provider (NPI-1).
NPI number1861157323
StatusActive
Last updated in NPPESNov 1, 2021
Details
- NPI
- 1861157323
- Entity type
- Individual (NPI-1)
- Name
- Brian Roach
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 1, 2021
- Certification date
- Nov 1, 2021
- Last updated
- Nov 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 62.002023 | CT | Yes |
Practice location
175 Sherman AveNew Haven, CT 06511-4357
Phone 203-789-3271
Mailing address
50 Eastern PkwyMilford, CT 06460-5001
Phone 203-907-9462
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