Provider Demographics
NPI:1154091403
Name:ROBA PHYSICAL THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:ROBA PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SOTIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-963-3501
Mailing Address - Street 1:178 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-2251
Mailing Address - Country:US
Mailing Address - Phone:508-963-3501
Mailing Address - Fax:
Practice Address - Street 1:2434 BERLIN TPKE STE 14
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-4122
Practice Address - Country:US
Practice Address - Phone:860-687-9700
Practice Address - Fax:860-422-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy