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NPI Code Detail

MEDICARE: DR. RANDOLPH LEE TROWBRIDGE MD

MEDICARE: DR. RANDOLPH LEE TROWBRIDGE MD
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
1208100000XPhysical Medicine & Rehabilitation Physician030869CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010030869CT02OTHERCTBLUE CROSS
22V6141OTHERCTHEALTH NET

General Provider Information

NPI Number : 1720098247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDOLPH LEE TROWBRIDGE MD
Provider Business Mailing Address
First Line : 22 EAGLE RD
Second Line :
City : DANBURY
State : CT
Zip : 06810-4129
Country : US
Telephone Number : 203-778-8326
Fax Number : 203-792-9170
Provider Business Practice Location Address
First Line : 22 EAGLE RD
Second Line :
City : DANBURY
State : CT
Zip : 06810-4129
Country : US
Telephone Number : 203-778-8326
Fax Number : 203-792-9170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 02/28/2008

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