Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 008398 | CT |
NPI | 1003067323 |
---|---|
Provider Name | Jennifer Kaminski |
First Address | New Fairfield, CT 06812-4823 |
Second Address | New Fairfield, CT 06812-4823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 09/10/2015 |