Individual provider Active NPI

Christine Anne Kozak, PT

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1699908905
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00769200 Issued in NJ
Practice address
80 James St
Edison, NJ 08820-3938
Phone
(908) 668-2892
NPI assigned
Sep 2, 2009
Last updated
Sep 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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 40QA00769200 NJ Primary

Addresses

Primary practice location

80 James St
Edison, NJ 08820-3938

Mailing address

80 James St
Edison, NJ 08820-3938

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00769200NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1699908905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203938",
            "telephone_number": "908-668-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "CHRISTINE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00769200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.