1033105648 NPI number — PETER S ZIELINSKI PHYSICAL THERAPY PC

Table of content: (NPI 1033105648)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033105648 NPI number — PETER S ZIELINSKI PHYSICAL THERAPY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER S ZIELINSKI PHYSICAL THERAPY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033105648
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
181 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06468-1110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-445-9843
Provider Business Mailing Address Fax Number:
203-445-9847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
181 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06468-1110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-445-9843
Provider Business Practice Location Address Fax Number:
203-445-9847
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ZIELINSKI
Authorized Official First Name:
PETER
Authorized Official Middle Name:
STANLEY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-445-9843

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50ZIELINSCT01 . This is a "BLUE CROSS GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: G1101768 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2V5870 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: C02597 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2270493 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37901 . This is a "ORTHO NET" identifier . This identifiers is of the category "OTHER".




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