Active NPI
Marie Jeannette Czarnecki, PT, DPT
- Physical Therapist
- Farmington, CT
National Provider Identifier
1780319517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11908
- Practice address
- 304 Main St # a
Farmington, CT 06032-2985 - Phone
- (860) 674-1824
- NPI assigned
- Jul 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 23960 | MA | |
| Physical Therapist | 225100000X | 11908 | CT | Primary |
Addresses
Primary practice location
304 Main St # a
Farmington, CT 06032-2985
Mailing address
1008 Misty Meadow LN
South Windsor, CT 06074-3653
Phone (860) 502-7976
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 |
|---|---|---|---|
| 11908 | CT | MD | Physical Therapist |
| 23960 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658016000000",
"number": "1780319517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 MISTY MEADOW LN",
"city": "SOUTH WINDSOR",
"state": "CT",
"postal_code": "060743653",
"telephone_number": "860-502-7976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 MAIN ST # A",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322985",
"telephone_number": "860-674-1824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZARNECKI",
"first_name": "MARIE",
"middle_name": "JEANNETTE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-17",
"last_updated": "2022-07-17",
"certification_date": "2022-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "23960",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "11908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.