Provider Demographics
NPI:1396956355
Name:PURSLOW, ROBERT WILLIAM (MSPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:PURSLOW
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1063
Mailing Address - Country:US
Mailing Address - Phone:203-939-9397
Mailing Address - Fax:203-286-1406
Practice Address - Street 1:454 MAIN AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1063
Practice Address - Country:US
Practice Address - Phone:203-939-9397
Practice Address - Fax:203-286-1406
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029149225100000X
CT9820225100000X
CT009820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist