Christopher John Stankiewicz Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013783 Issued in CT

Practice address

462 Washington Ave
Units 1-3
North Haven, CT 06473

Phone

(203) 745-4973

Fax

(203) 821-7417

NPI assigned

Apr 16, 2019

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in CT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revive Therapy LLC

  • Physical Therapy Clinic/Center
  • North Haven, CT
  • NPI 1528527942

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1205499266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LAKE RD",
            "city": "NORTH BRANFORD",
            "state": "CT",
            "postal_code": "064711253",
            "telephone_number": "203-871-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 WASHINGTON AVE",
            "address_2": "UNITS 1-3",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-745-4973",
            "fax_number": "203-821-7417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Lake Rd",
            "address_purpose": "LOCATION",
            "city": "North Branford",
            "state": "CT",
            "postal_code": "064711253",
            "country_code": "US",
            "telephone_number": "203-871-9662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "336 State St Ste 2-3",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064733170",
            "country_code": "US",
            "telephone_number": "203-745-4973",
            "fax_number": "203-821-7417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANKIEWICZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "013783",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SPH North Haven LLC (Complete Dental)
• Adriana Spino, APRN
• St. Raphael Dialysis Center Partnership (North Haven Dialysis Center)
• William Stallings, DPM
• Elizabeth Michelle Stammel
• Lisbeth CM Steen, DMD
• Denise Stein, LPC
• Erica Stevens
• Kaitlyn Stokarski
• Elsa L Stone, M.D.

• Physical Therapist in North Haven, CT
• Providers in North Haven, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.