Individual provider Active NPI

Katarzyna Joanna Gonciarz

  • Pediatric Physical Therapist
  • East Syracuse, NY
National Provider Identifier
1285887539
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
023145-1 Issued in NY
Practice address
5820 Heritage Landing Dr
East Syracuse, NY 13057-9378
Phone
(315) 701-1107
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 023145-1 NY Primary

Addresses

Primary practice location

5820 Heritage Landing Dr
East Syracuse, NY 13057-9378

Mailing address

7936 State Route 104
Oswego, NY 13126-5623
Phone (315) 342-4476

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

LicenseStateTypeSpecialty
023145-1NYMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1285887539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7936 STATE ROUTE 104",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131265623",
            "telephone_number": "315-342-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 HERITAGE LANDING DR",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579378",
            "telephone_number": "315-701-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCIARZ",
        "first_name": "KATARZYNA",
        "middle_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "023145-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.

Verify at the official NPI Registry.