Provider Demographics
NPI:1881328037
Name:MIL, ROBERT ANDRZEJ
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANDRZEJ
Last Name:MIL
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 1:187 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1163
Mailing Address - Country:US
Mailing Address - Phone:860-478-9390
Mailing Address - Fax:
Practice Address - Street 1:187 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1163
Practice Address - Country:US
Practice Address - Phone:860-478-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1092225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant