Active NPI
Janet M Lisak, MOT,OTR,CHT
- Occupational Therapist
- Waterbury, CT
National Provider Identifier
1225272321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 003534
- Practice address
- 1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708 - Phone
- (203) 755-7115
- Fax
- (203) 755-7067
- NPI assigned
- Apr 21, 2009
- Last updated
- Sep 21, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 003534 | CT | Primary |
Addresses
Primary practice location
1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708
Mailing address
1320 West Main Street
Building 2, the Hand to Shoulder Center, LLC
Waterbury, CT 06708
Phone (203) 755-7115
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003534 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1225272321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 WEST MAIN STREET",
"address_2": "BUILDING 2, THE HAND TO SHOULDER CENTER, LLC",
"city": "WATERBURY",
"state": "CT",
"postal_code": "06708",
"telephone_number": "203-755-7115",
"fax_number": "203-755-7067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 WEST MAIN STREET",
"address_2": "BUILDING 2, THE HAND TO SHOULDER CENTER, LLC",
"city": "WATERBURY",
"state": "CT",
"postal_code": "06708",
"telephone_number": "203-755-7115",
"fax_number": "203-755-7067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISAK",
"first_name": "JANET",
"middle_name": "M",
"credential": "MOT,OTR,CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-21",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "003534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.