Provider Demographics
NPI:1053379925
Name:POZZI, KEVIN MICHAEL (PT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:POZZI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S RIVER RD UNIT 58
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6751
Mailing Address - Country:US
Mailing Address - Phone:603-626-4205
Mailing Address - Fax:603-668-9943
Practice Address - Street 1:40 S RIVER RD UNIT 58
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6751
Practice Address - Country:US
Practice Address - Phone:603-626-4205
Practice Address - Fax:603-668-9943
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3037225100000X
VA2305206734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393740Medicaid
NH30393740Medicaid