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NPI Code Detail

MEDICARE: JOSEPH ROBERT KEARNS MS, PT, OCS

MEDICARE: JOSEPH ROBERT KEARNS MS, PT, OCS
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
1225100000XPhysical Therapist006546CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10800006546CT01OTHERCTBLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number : 1750331518
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH ROBERT KEARNS MS, PT, OCS
Provider Business Mailing Address
First Line : 1171 E PUTNAM AVE
Second Line :
City : RIVERSIDE
State : CT
Zip : 06878-1426
Country : US
Telephone Number : 203-637-1700
Fax Number : 203-637-5447
Provider Business Practice Location Address
First Line : 1171 E PUTNAM AVE
Second Line :
City : RIVERSIDE
State : CT
Zip : 06878-1426
Country : US
Telephone Number : 203-637-1700
Fax Number : 203-637-5447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 12/26/2007

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