Active NPI
Sergey Rudyak
- Physical Therapy Assistant
- Rocky Hill, CT
National Provider Identifier
1679482525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 002190
- Practice address
- 12 Beecher LN
Rocky Hill, CT 06067-3237 - Phone
- (860) 218-3402
- NPI assigned
- Sep 4, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 002190 | CT | Primary |
Addresses
Primary practice location
12 Beecher LN
Rocky Hill, CT 06067-3237
Mailing address
12 Beecher LN
Rocky Hill, CT 06067-3237
Phone (860) 218-3402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1679482525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 BEECHER LN",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060673237",
"telephone_number": "860-218-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 BEECHER LN",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060673237",
"telephone_number": "860-218-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDYAK",
"first_name": "SERGEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-04",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "002190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocky Hill, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.