Stephanie Mary Kasulke

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

004413 Issued in CT

Practice address

36 Firetown Rd
Governor'S House Nursing Home
Simsbury, CT 06070-1965

Phone

(860) 658-1018

NPI assigned

Aug 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1124427406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 FIRETOWN RD",
            "address_2": "GOVERNOR'S HOUSE NURSING HOME",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701965",
            "telephone_number": "860-658-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 FIRETOWN RD",
            "address_2": "GOVERNOR'S HOUSE NURSING HOME",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701965",
            "telephone_number": "860-658-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASULKE",
        "first_name": "STEPHANIE",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018673-1",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CT",
            "license": "004413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph and Erica Petitti
• Susan Elizabeth Joyce, NCC, LPC, LMHC
• Lukasz W Junger, APRN
• Zachary A Kahn, D.O.
• Bruce Michael Kaplan, M.D.
• Diana Anna Keder, DMD
• Rebecca Mooar Kelleher, D.D.S.
• Kenneth R Finn DMD LLC
• Robert C Kevorkian, RPH
• Marvin Saul Koff, M.D.

• Physical Rehabilitation Occupational Therapist in Simsbury, CT
• Providers in Simsbury, CT by specialty
• Physical Rehabilitation Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.