Provider Demographics
NPI:1508961889
Name:WILLIAMS, BRIAN TIMOTHY (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:TIMOTHY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MS, PT
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Mailing Address - Street 1:155 HILL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3192
Mailing Address - Country:US
Mailing Address - Phone:203-882-9384
Mailing Address - Fax:203-882-9385
Practice Address - Street 1:155 HILL ST
Practice Address - Street 2:SUITE B
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3192
Practice Address - Country:US
Practice Address - Phone:203-882-9384
Practice Address - Fax:203-882-9385
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT4793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000483Medicare ID - Type UnspecifiedMC ID #