Jessica Bocek, PT, DPT

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Southington, CT

NPI 1265197461 · NPPES record last updated Nov 2, 2021

Key facts

NPI
1265197461
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
12746 (CT)
Practice address
45 Evergreen LN
Southington, CT 06489-2705
Phone
(860) 919-6353
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12746CTMDPhysical Medicine & Rehabilitation Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 12746 CT Yes

Addresses

Primary practice location

45 Evergreen LN
Southington, CT 06489-2705

Mailing address

45 Evergreen LN
Southington, CT 06489-2705
Phone (860) 919-6353

Other providers in Southington, CT

All providers in Southington, CT · Physical Medicine & Rehabilitation Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.