Active NPI
Mark William Hornyak, PTA
- Physical Therapy Assistant
- Wallingford, CT
National Provider Identifier
1598960411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 000259
- Practice address
- 22 Masonic Ave
Wallingford, CT 06492-3048 - Phone
- (203) 679-5407
- Fax
- (203) 679-6142
- NPI assigned
- Jun 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 000259 | CT | Primary |
Addresses
Primary practice location
22 Masonic Ave
Wallingford, CT 06492-3048
Mailing address
45 Pent Rd
Branford, CT 06405-4005
Phone (203) 488-0292
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 |
|---|---|---|---|
| 000259 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1598960411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 PENT RD",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064054005",
"telephone_number": "203-488-0292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 MASONIC AVE",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064923048",
"telephone_number": "203-679-5407",
"fax_number": "203-679-6142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORNYAK",
"first_name": "MARK",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-20",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "000259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.