Paul Robert Berry, P.T.

Individual provider Active NPI Physical Therapist · Newtown, CT

NPI 1528045176 · NPPES record last updated Dec 10, 2009

Key facts

NPI
1528045176
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
001915 (CT)
Practice address
103 S Main St
Newtown, CT 06470-2372
Phone
(203) 270-0330
Fax
(203) 270-0330
NPI assigned
Dec 26, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1915CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Paul R & Stephanie K Berry Dba Physical Therapy Consultants Physical Therapist Past
since Jan 1, 1990
Accepting new patients
Paul R Berry Physical Therapist Past
since Jan 1, 1990
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 001915 CT Yes

Addresses

Primary practice location

103 S Main St
Newtown, CT 06470-2372

Mailing address

103 S Main St
Newtown, CT 06470-2372
Phone (203) 270-0330

Other identifiers

IdentifierTypeStateIssuer
ZS968OtherCTOXFORD HEALTH PLANS
0Q774710OtherEMPIRE BLUE CROSS BLUE SH
104823000OtherDOL FECA
0019501OtherCTAETNA ORTHONET
041801OtherCTHEALTHNET
080001915CT02OtherCTANTHEM BLUE CROSS &BLUE S
19501OtherCIGNA ORTHONET
0565313OtherAETNA
207806OtherWELLCARE

Other providers in Newtown, CT

All providers in Newtown, CT · Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.