Ian Brokaw, DPT is a
Physical Medicine & Rehabilitation physician based in Canton, Connecticut. Ian Brokaw is licensed to practice in Connecticut (license number 10642) and his current practice location is 65 Albany Tpke, Canton, Connecticut. He can be reached at his office (for appointments etc.) via phone at
(860) 693-6226.
NPI number for Ian Brokaw is 1356838262 and his current mailing address is Po Box 466, Canton, Connecticut. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356838262.
Physician's Profile
| Full Name | Ian Brokaw |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 65 Albany Tpke, Canton, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356838262
- Provider Enumeration Date: 04/16/2018
- Last Update Date: 04/16/2018
Medical Identifiers
Medical identifiers for Ian Brokaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356838262 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 10642 (Connecticut) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 10642 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ian Brokaw is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ian Brokaw, DPT
Po Box 466,
Canton, CT 06019-0466
Ph: (860) 693-6226 | Ian Brokaw, DPT
65 Albany Tpke,
Canton, CT 06019-2507
Ph: (860) 693-6226 |
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