Individual provider Active NPI

Lynn Fazzino, PT

  • Physical Therapist
  • New Britain, CT
National Provider Identifier
1629604905
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2712 Issued in CT
Practice address
Cora
136 West Main St
New Britain, CT 06052
Phone
(860) 801-6171
Fax
(860) 826-4765
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2712 CT Primary

Addresses

Primary practice location

Cora
136 West Main St
New Britain, CT 06052

Mailing address

Cora
136 West Main St
New Britain, CT 06052
Phone (860) 801-6171

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
2712CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1629604905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CORA",
            "address_2": "136 WEST MAIN ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06052",
            "telephone_number": "860-801-6171",
            "fax_number": "860-826-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORA",
            "address_2": "136 WEST MAIN ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06052",
            "telephone_number": "860-801-6171",
            "fax_number": "860-826-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZINO",
        "first_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "2712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.