Provider Demographics
NPI:1801874201
Name:VERWEIJ, WILLEM (PT)
Entity type:Individual
Prefix:
First Name:WILLEM
Middle Name:
Last Name:VERWEIJ
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 1:306 N. MAIN STREET, UNIT 5
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4353
Mailing Address - Country:US
Mailing Address - Phone:603-335-4700
Mailing Address - Fax:603-335-4704
Practice Address - Street 1:306 N. MAIN STREET, UNIT 5
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4353
Practice Address - Country:US
Practice Address - Phone:603-335-4700
Practice Address - Fax:603-335-4704
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3434257OtherAETNA
0128756OtherCIGNA
08Y005532NH01OtherANTHEM
NH30392805Medicaid
205224400OtherUS DOL / WORKER'S COMP
0128756OtherCIGNA