Doctor Name: | MR. THOMAS KISATSKY |
NPI Number: | 1053413419 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 000428 |
Business Practice Address: | 22 Tompkins St Waterbury, CT - 067081417 |
Business Phone Number: | 2034190381 |
Business Fax Number: | 2034190389 |
Mailing Address: | 315 Williamson Cir, OAKVILLE |
State: | CT |
Postal Code: | 067792028 |
Phone Number: | 8602743260 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 000428 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |