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NPI Code Detail

MEDICARE: MR. ROBERT W METZLER IV MSW, LMSW

MEDICARE: MR. ROBERT W METZLER IV MSW, LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerMA
21041C0700XClinical Social Worker3710CT

General Provider Information

NPI Number : 1366815235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT W METZLER IV MSW, LMSW
Provider Business Mailing Address
First Line : 331 WETHERSFIELD AVE STE 2
Second Line :
City : HARTFORD
State : CT
Zip : 06114-1438
Country : US
Telephone Number : 860-236-4511
Fax Number :
Provider Business Practice Location Address
First Line : 331 WETHERSFIELD AVE STE 2
Second Line :
City : HARTFORD
State : CT
Zip : 06114-1438
Country : US
Telephone Number : 860-236-4511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2015
Last Update Date : 07/31/2019

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