Active NPI
Edward Bonk
- Physical Therapist
- Manchester, CT
National Provider Identifier
1194635136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003612
- Practice address
- 66 Walker St
Manchester, CT 06040-4330 - Phone
- (860) 682-4048
- NPI assigned
- Sep 10, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003612 | CT | Primary |
Addresses
Primary practice location
66 Walker St
Manchester, CT 06040-4330
Mailing address
66 Walker St
Manchester, CT 06040-4330
Phone (860) 682-4048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1194635136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WALKER ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404330",
"telephone_number": "860-682-4048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 WALKER ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404330",
"telephone_number": "860-682-4048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONK",
"first_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CT",
"license": "003612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.