Individual provider Active NPI

Priscilla Jan Kowal, MPT,COTA/L

  • Physical Therapist
  • Enfield, CT
National Provider Identifier
1124263686
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007283 Issued in CT
Practice address
143 Hazard Ave
Enfield, CT 06082-4521
Phone
(860) 763-2225
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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 007283 CT Primary

Addresses

Primary practice location

143 Hazard Ave
Enfield, CT 06082-4521

Mailing address

143 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 763-2225

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
007283CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1124263686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-763-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-763-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWAL",
        "first_name": "PRISCILLA",
        "middle_name": "JAN",
        "credential": "MPT,COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "007283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.