Provider Demographics
NPI:1457181737
Name:ZECHA III, FREDERICK P (DPT)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:P
Last Name:ZECHA III
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 BROAD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3273
Mailing Address - Country:US
Mailing Address - Phone:203-693-3754
Mailing Address - Fax:203-283-3908
Practice Address - Street 1:247 BROAD ST STE 3
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3273
Practice Address - Country:US
Practice Address - Phone:203-693-3754
Practice Address - Fax:203-283-3908
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist