Active NPI
Laura Koziatek, RPT
- Physical Therapist
- Waterford, CT
National Provider Identifier
1255506648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 002433
- Practice address
- 4 Greentree Dr
Waterford, CT 06385-4116 - Phone
- (860) 442-0647
- Fax
- (860) 437-0123
- NPI assigned
- Apr 25, 2008
- Last updated
- Apr 25, 2008
- Sex
- Female
- 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 | 002433 | CT | Primary |
Addresses
Primary practice location
4 Greentree Dr
Waterford, CT 06385-4116
Mailing address
32 Upper Walnut Hill Rd
East Lyme, CT 06333-1021
Phone (860) 440-0764
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002433 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209081600000",
"number": "1255506648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 UPPER WALNUT HILL RD",
"city": "EAST LYME",
"state": "CT",
"postal_code": "063331021",
"telephone_number": "860-440-0764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 GREENTREE DR",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063854116",
"telephone_number": "860-442-0647",
"fax_number": "860-437-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZIATEK",
"first_name": "LAURA",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-25",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "002433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.