Provider Demographics
NPI:1295776250
Name:RAPOSA, ROBIN LYNN (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:RAPOSA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SOUTH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4124
Mailing Address - Country:US
Mailing Address - Phone:203-431-7632
Mailing Address - Fax:203-431-9259
Practice Address - Street 1:10 SOUTH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4124
Practice Address - Country:US
Practice Address - Phone:203-431-7632
Practice Address - Fax:203-431-9259
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02446OtherMEDICARE GROUP