Provider Demographics
NPI:1891785176
Name:BESSON, GREG (MSPT)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:BESSON
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 1:1250 SUMMER ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5358
Mailing Address - Country:US
Mailing Address - Phone:203-975-1545
Mailing Address - Fax:203-975-1544
Practice Address - Street 1:1250 SUMMER ST
Practice Address - Street 2:SUITE 204
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5358
Practice Address - Country:US
Practice Address - Phone:203-975-1545
Practice Address - Fax:203-975-1544
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist