Mandy Baniszewski

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12995 Issued in CT

Practice address

655 Main St S
Southbury, CT 06488-4220

Phone

(877) 407-3422

Fax

(877) 407-4329

NPI assigned

May 5, 2021

Last updated

May 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1013590199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884220",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANISZEWSKI",
        "first_name": "MANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Auger, R.D.H.
• Cassidy Lee Bailey
• Stephanie L. Bakewell, AUDIOLOGIST
• Lisa Baldelli, SLP
• Laura Baltzell, MSW
• Mary Jacqueline Banning, PT
• Sarah Bannon
• Barbara a. Kilkenny, DPM
• Barbara a. Kilkenny, PC
• Barbell Physical Therapy and Performance, LLC

• Physical Therapist in Southbury, CT
• Providers in Southbury, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.