Active NPI
Marc I Robertson
- Physical Therapist
- New Haven, CT
National Provider Identifier
1033132006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 006225
- Practice address
- 339 Eastern St
Suite 317
New Haven, CT 06513 - Phone
- (203) 468-7002
- Fax
- (203) 468-7078
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006225 | CT | Primary |
Addresses
Primary practice location
339 Eastern St
Suite 317
New Haven, CT 06513
Mailing address
733 South Main St
Cheshire, CT 06410
Phone (203) 272-7368
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2467781 | Other | AETNA | |
| 080006225CT02 | Other | CT | ANTHEM BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033132006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "733 SOUTH MAIN ST",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "06410",
"telephone_number": "203-272-7368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 EASTERN ST",
"address_2": "SUITE 317",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06513",
"telephone_number": "203-468-7002",
"fax_number": "203-468-7078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "MARC",
"middle_name": "I",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "006225",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2467781",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "080006225CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.