Gombotz, Mark
Gombotz, Mark is an individual health care provider with primary practice located at 6 Davis Rd E , Old Lyme CT 06371-1447. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Gombotz, Mark can be contacted via phone (860) 434-9155.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X |
Profile Details
| NPI number | 1922116185 |
|---|---|
| LBN Legal business name | Gombotz, Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922116185 | NPPES |
| Connecticut | Other | 005690 | LICENSE # |
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