Provider Demographics
NPI:1659752871
Name:ABADILLA, REY ANTHONY
Entity type:Individual
Prefix:
First Name:REY ANTHONY
Middle Name:
Last Name:ABADILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 NEW HAVEN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6661
Mailing Address - Country:US
Mailing Address - Phone:475-209-1606
Mailing Address - Fax:
Practice Address - Street 1:318 NEW HAVEN AVE STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-6661
Practice Address - Country:US
Practice Address - Phone:475-209-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist