Individual provider Active NPI

Anna Pukajlo-Kwasniewska, PT

  • Physical Therapist
  • Burlington, NJ
National Provider Identifier
1124242722
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01233900 Issued in NJ
Practice address
2305 Rancocas Rd
Burlington, NJ 08016-4113
Phone
(609) 747-8619
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01233900 NJ Primary

Addresses

Primary practice location

2305 Rancocas Rd
Burlington, NJ 08016-4113

Mailing address

888 Spruce St
Lawrenceville, NJ 08648-4530
Phone (609) 393-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01233900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Apr 2, 2022 Accepting new patients

Locations

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124242722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 SPRUCE ST",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086484530",
            "telephone_number": "609-393-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 RANCOCAS RD",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164113",
            "telephone_number": "609-747-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUKAJLO-KWASNIEWSKA",
        "first_name": "ANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01233900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.