Provider Demographics
NPI:1700902210
Name:ARCARI, KEITH (PT)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:ARCARI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1859
Mailing Address - Country:US
Mailing Address - Phone:860-788-7976
Mailing Address - Fax:877-532-7987
Practice Address - Street 1:270 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1859
Practice Address - Country:US
Practice Address - Phone:860-788-7976
Practice Address - Fax:877-532-7987
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist