Doctor Name: | PETER G BOUDO |
NPI Number: | 1255396743 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 005971 |
Business Practice Address: | 14 Jones Hollow Rd Ste 7 Marlborough, CT - 064471448 |
Business Phone Number: | 8602958188 |
Business Fax Number: | 8609867459 |
Mailing Address: | Po Box 8, EAST HAMPTON |
State: | CT |
Postal Code: | 064240008 |
Phone Number: | 8602678500 |
Fax Number: | 8609867459 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 005971 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |