Active NPI
Preetha Krishnamoorthy, PT
- Specialist
- Derby, CT
National Provider Identifier
1295901346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 008312
- Practice address
- 210 Chatfield St
Derby, CT 06418-1150 - Phone
- (203) 735-7402
- NPI assigned
- May 7, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 008312 | CT | Primary |
Addresses
Primary practice location
210 Chatfield St
Derby, CT 06418-1150
Mailing address
4102 Town Walk Dr
Hamden, CT 06518-3735
Phone (616) 304-7398
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 |
|---|---|---|---|
| 008312 | CT | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1295901346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 TOWN WALK DR",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065183735",
"telephone_number": "616-304-7398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 CHATFIELD ST",
"city": "DERBY",
"state": "CT",
"postal_code": "064181150",
"telephone_number": "203-735-7402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRISHNAMOORTHY",
"first_name": "PREETHA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-07",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CT",
"license": "008312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.