Karen B Mizrachi, OT
Individual provider Active NPI Contractor · Stamford, CT
NPI 1376779462 · NPPES record last updated Jun 3, 2009
Key facts
- NPI
- 1376779462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 012569 (NY)
- Practice address
- 22 Vincent Ave
Stamford, CT 06905-4022 - Phone
- (203) 536-0279
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012569 | NY | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 012569 | NY | Yes |
Addresses
Primary practice location
22 Vincent Ave
Stamford, CT 06905-4022
Mailing address
22 Vincent Ave
Stamford, CT 06905-4022
Phone (203) 536-0279
Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.