Mariusz Wdowiak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

000599 Issued in CT

Practice address

38 Nanel Dr Apt B
Glastonbury, CT 06033-2256

Phone

(860) 478-7583

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346461480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 NANEL DR APT B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332256",
            "telephone_number": "860-478-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 NANEL DR APT B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332256",
            "telephone_number": "860-478-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WDOWIAK",
        "first_name": "MARIUSZ",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "20766",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000599",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "7392A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Ward, L.C.S.W.
• Sheryll Ann Waring, LPC LADC
• Eugene Peter Warnick III, MD
• Alissa Watson, APRN
• WCG CT PLLC
• Jennifer Anne Webb, D.V.M.
• Natalie C Webb, MD
• Kelly Tahaney Weber, PSYD
• Shamichae D. Weidman, PHARMD
• Wellevate Counseling LLC

• Physical Therapy Assistant in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Physical Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.