Kristin Godiksen Physical Therapy and Wellness

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

002340 Issued in CT

Legal business name

KRISTIN GODIKSEN PHYSICAL THERAPY AND WELLNESS

Practice address

34 Jerome Ave Ste 305
Bloomfield, CT 06002-2463

Phone

(860) 431-0902

NPI assigned

Jul 12, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristin Godiksen, PT, IMTC

Title

Member

Phone

(860) 930-8230

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1255817326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 JEROME AVE STE 305",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022463",
            "telephone_number": "860-431-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 JEROME AVE STE 305",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022463",
            "telephone_number": "860-431-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN GODIKSEN PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "GODIKSEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-930-8230",
        "authorized_official_credential": "PT, IMTC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "002340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Marie Konieczny
• Carolyn Morrell Kosack, M.D.
• Adam Thomas Krakowiak
• Michael M Krinsky, MD
• Kris Albrecht LLC
• Michael P Kruger, MD
• Michele Krynski, PHD
• Ranjani Kurukulasuriya, MD
• Angela Labella, PT
• Jean M Lafayette, DDS

• Physical Therapy Clinic/Center in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.