Individual provider Active NPI

Kristen Traboulsi, PT

  • Physical Therapist
  • West Hartford, CT
National Provider Identifier
1154543007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CT007094 Issued in CT
Practice address
One Abrahms Boulevard
West Hartford, CT 06117
Phone
(860) 523-3868
Fax
(860) 523-3819
NPI assigned
May 2, 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 CT007094 CT Primary

Addresses

Primary practice location

One Abrahms Boulevard
West Hartford, CT 06117

Mailing address

20 Scott Lane
Windsor, CT 06095
Phone (860) 687-0811

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CT007094CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154543007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SCOTT LANE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "06095",
            "telephone_number": "860-687-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ABRAHMS BOULEVARD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06117",
            "telephone_number": "860-523-3868",
            "fax_number": "860-523-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRABOULSI",
        "first_name": "KRISTEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "CT007094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

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.