Provider Demographics
NPI:1134741598
Name:PHELAN, WILLIAM J III (RRT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:PHELAN
Suffix:III
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 DORIS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2107
Mailing Address - Country:US
Mailing Address - Phone:203-258-9169
Mailing Address - Fax:
Practice Address - Street 1:ONE HOSPITAL PLAZA
Practice Address - Street 2:RESPIRATORY THERAPY DEPT
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-276-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001072227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered