Lynn Marie Wisniewski, PT – Physical Therapist

Key facts

NPI: 1174532170
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 004210 (CT)
Practice address: 1666 Route 12
Gales Ferry, CT 06360
Phone: (860) 464-1949
Fax: (860) 464-3118
NPI assigned: Aug 7, 2006
Sex: Female
Sole proprietor: No

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.

Connecticut Neuropsychological Associates, LLC Clinical Psychologist · Norwich, CT · NPI 1497151245

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Connecticut Neuropsychological Associates, LLC		Past since Nov 20, 2014	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	004210	CT	Yes

Addresses

Primary practice location

1666 Route 12
Gales Ferry, CT 06360

Mailing address

150 Otrobando Ave
Norwich, CT 06360
Phone (860) 889-1948

Other identifiers

Identifier	Type	State	Issuer
080004210CT01	Other	CT	BCBS
080004210CT022	Other	CT	ANTHEM BCBS
080004210CT23	Other	CT	ANTHEM BCBS
080004210CT024	Other	CT	ANTHEM BCBS
080004210CT02	Other	CT	ANTHEM BCBS

Other providers in Gales Ferry, CT

All providers in Gales Ferry, CT · Physical Therapist in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.