Provider Demographics
NPI:1336724822
Name:FORCELLI, PETER (MS, BSRT, RRT-ACCS)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:FORCELLI
Suffix:
Gender:M
Credentials:MS, BSRT, RRT-ACCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SARAS WAY
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2949
Mailing Address - Country:US
Mailing Address - Phone:203-650-7608
Mailing Address - Fax:
Practice Address - Street 1:3 SARAS WAY
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2949
Practice Address - Country:US
Practice Address - Phone:203-650-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001972227900000X
NY009444-1227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered