Mr Kevin T Russell, BS, MSPT | |
111 Goose Lane, Ste 2500, Guilford, CT 06437 | |
(203) 453-0134 | |
(203) 453-0167 |
Full Name | Mr Kevin T Russell |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 111 Goose Lane, Guilford, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881601318 | NPI | - | NPPES |
080004359CT04 | Other | CT | BLUE CROSS BLUE SHEILD |
004133906 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 4359 (Connecticut) | Primary |
Provider Name | Ptsma Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1033773759 PECOS PAC ID: 7911800180 Enrollment ID: O20190712000494 |
Mailing Address | Practice Location Address |
---|---|
Mr Kevin T Russell, BS, MSPT 111 Goose Lane, Suite 2500, Guilford, CT 06437 Ph: (203) 453-0134 | Mr Kevin T Russell, BS, MSPT 111 Goose Lane, Ste 2500, Guilford, CT 06437 Ph: (203) 453-0134 |
Mary Mazor Callis, RPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 450 Boston Post Rd, Guilford, CT 06437 Phone: 203-453-0459 Fax: 203-466-8527 | |
Mrs. Mary Jane Fegan, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 753 Boston Post Rd, Suite 101, Guilford, CT 06437 Phone: 203-458-6268 | |
Zachary J Currie, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 385 Church St Ste 103, Guilford, CT 06437 Phone: 203-453-2844 Fax: 203-453-8772 | |
Mrs. Dawn Maria Barber, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 753 Boston Post Rd, Suite 101, Guilford, CT 06437 Phone: 203-458-6268 Fax: 203-458-9230 | |
Eric Meoli, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 705 Boston Post Rd Ste 5a, Guilford, CT 06437 Phone: 203-458-1645 Fax: 203-458-1689 | |
Stephanie Rose Weady, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 753 Boston Post Road Suite 101, Guilford, CT 06437 Phone: 203-458-6268 | |
Janelle Diane Mcelhany, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 399 Weatherly Trl, Guilford, CT 06437 Phone: 203-640-0792 |