Lina Klossek

Key facts

NPI

1003546706

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

Practice address

540 Bordentown Ave Ste 10B
South Amboy, NJ 08879-1576

Phone

(732) 553-1600

NPI assigned

Jun 15, 2022

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 15, 2022.

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1003546706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 ISIAS CT",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088615229",
            "telephone_number": "908-943-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVE STE 10B",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791576",
            "telephone_number": "732-553-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSSEK",
        "first_name": "LINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in South Amboy, NJ · Physical Therapy Assistant in New Jersey