Active NPI
Edward Barry Kravitz, MS, ATC, LAT
- Athletic Trainer
- New Haven, CT
National Provider Identifier
1942423710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000118
- Practice address
- 230 George St
New Haven, CT 06510-3224 - Phone
- (203) 498-5980
- NPI assigned
- Apr 10, 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000118 | CT | Primary |
Addresses
Primary practice location
230 George St
New Haven, CT 06510-3224
Mailing address
466 S Elm St
Wallingford, CT 06492-4817
Phone (860) 805-7259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PROVIDER CODE 22 | Other | CT | RESPIRATORY, REHABILITATI |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000118 | CT | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942423710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "466 S ELM ST",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064924817",
"telephone_number": "860-805-7259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 GEORGE ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103224",
"telephone_number": "203-498-5980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAVITZ",
"first_name": "EDWARD",
"middle_name": "BARRY",
"name_prefix": "Mr.",
"credential": "MS, ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, REHABILITATI",
"identifier": "PROVIDER CODE 22",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.