Active NPI
Lauri F. Boscarino
- Pediatric Physical Therapist
- Ellington, CT
National Provider Identifier
1972734473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 003305
- Practice address
- 84 Snipsic Lake Rd
Ellington, CT 06029-3519 - Phone
- (860) 633-1016
- Fax
- (860) 875-6423
- NPI assigned
- Jul 31, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 003305 | CT | Primary |
Addresses
Primary practice location
84 Snipsic Lake Rd
Ellington, CT 06029-3519
Mailing address
76 Eastern Blvd
Suite 101
Glastonbury, CT 06033-4382
Phone (860) 633-1016
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 |
|---|---|---|---|
| 003305 | CT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediaflex Therapy Center, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Physical Therapist
- Wethersfield, CT
- NPI 1972686533
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248998400000",
"number": "1972734473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 EASTERN BLVD",
"address_2": "SUITE 101",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060334382",
"telephone_number": "860-633-1016",
"fax_number": "860-875-6423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 SNIPSIC LAKE RD",
"city": "ELLINGTON",
"state": "CT",
"postal_code": "060293519",
"telephone_number": "860-633-1016",
"fax_number": "860-875-6423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCARINO",
"first_name": "LAURI",
"middle_name": "F.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-31",
"last_updated": "2009-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CT",
"license": "003305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.