Provider Demographics
NPI:1386968725
Name:ROBILLARD, LENORE ROKOSA (PT)
Entity type:Individual
Prefix:MRS
First Name:LENORE
Middle Name:ROKOSA
Last Name:ROBILLARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 POSA DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5476
Mailing Address - Country:US
Mailing Address - Phone:860-583-5061
Mailing Address - Fax:
Practice Address - Street 1:42 POSA DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5476
Practice Address - Country:US
Practice Address - Phone:860-583-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0026402251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics