Provider Demographics
NPI:1619910965
Name:STEBBINS, RICHARD FRANCES (PT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FRANCES
Last Name:STEBBINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6779
Mailing Address - Country:US
Mailing Address - Phone:203-992-1220
Mailing Address - Fax:203-992-1219
Practice Address - Street 1:323 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6779
Practice Address - Country:US
Practice Address - Phone:203-992-1220
Practice Address - Fax:203-992-1219
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080003943CT01OtherANTHEM BCBS PROVIDER #
CTANC866OtherOXFORD ORTHONET NUMBER
CT080003943CT01OtherANTHEM BCBS PROVIDER #