Provider Demographics
NPI:1063818581
Name:ECHEVERRY, HUGO (MSPT)
Entity Type:Individual
Prefix:
First Name:HUGO
Middle Name:
Last Name:ECHEVERRY
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SILANO DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-2719
Mailing Address - Country:US
Mailing Address - Phone:203-368-8655
Mailing Address - Fax:
Practice Address - Street 1:80 HERITAGE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1882
Practice Address - Country:US
Practice Address - Phone:866-817-8935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist