Brian R Wally (NPI# 1053760157, PAC ID# 9234425935) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1053760157 |
| PAC ID by PECOS | 9234425935 |
| Professional Enrollment ID | I20170905000591 |
| Full Name | Brian R Wally |
| Organization Legal Name | FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE LLC |
| Address |
190 Fenn Rd Newington CT 06111-2244 |
| Phone Number | 8608295511 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 6800970500 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 190 Fenn Rd, Newington, CT 06111-2244 | 8608295511 | FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE LLC |
| 185 Ocean St, South Portland, ME 04106-3623 | 2077998226 | BACK IN MOTION PHYSICAL THERAPY, LLC |
| Organization Legal Name | FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dylan Fallis | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 190 Fenn Rd, Newington, CT 06111-2244 |
| Kari A Callahan | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 1231 Farmington Ave, Berlin, CT 06037-2301 |
| Michael P Johnson | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 1231 Farmington Ave, Berlin, CT 06037-2301 |
| Marcus D Bacon | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 1231 Farmington Ave, Berlin, CT 06037-2301 |
| Steve Defrancesco | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 1231 Farmington Ave, Berlin, CT 06037-2301 |
| Anthony Laurenitis | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 1231 Farmington Ave, Berlin, CT 06037-2301 |
| Street Address |
190 FENN RD |
| City | NEWINGTON |
| State | CT |
| Zip | 06111-2244 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dylan Fallis | Physical Therapy | Focus Physical Therapy and Sports Medicine LLC | 190 Fenn Rd, Newington, CT 06111-2244 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana S Digiacomo-canellas | Clinical Social Worker | 705 N Mountain Rd, Suite C203, Newington, CT 06111-1432 | |
| Joel Roffer | Optometry | Myeyedr Optometry of Connecticut, LLC | 38 Fenn Rd, Newington, CT 06111-2212 |
| Cassandra Ruth Young | Optometry | Myeyedr. Optometry of Connecticut, LLC | 38 Fenn Rd, Newington, CT 06111-2212 |
| Carmen Stelea | Internal Medicine | Starling Physicians PC | 375 Willard Ave, Newington, CT 06111-2300 |
| Jeffrey M Kagan | Internal Medicine | Newington Internal Medicine Primary Care LLP | 365 Williard Ave, Suite 2d, Newington, CT 06111-2316 |
| Stuart C Calle | Emergency Medicine | 365 Willard Ave, 2e, Newington, CT 06111-2316 | |
| Turgut Yetil | Internal Medicine | Newington Internal Medicine Primary Care LLP | 365 Williard Ave, Suite 2d, Newington, CT 06111-2316 |
| Stacie L Zibel | Nurse Practitioner | Newington Internal Medicine Primary Care LLP | 365 Williard Ave, Suite 2d, Newington, CT 06111-2316 |
| Navaratnasingam A C Mohanraj | Internal Medicine | 365 Willard Ave, 2d, Newington, CT 06111-2316 | |
| Mitchel B Strand | Optometry | Totalvision Eye Health Center LLC | 485 Willard Ave, Newington, CT 06111-2318 |
| Find all physicians in zip 06111 | |||
| City | NEWINGTON |
| Zip Code | 06111 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | NEWINGTON + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Brian R Wally.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.