Provider Demographics
NPI:1063855849
Name:KUZMA, KEVIN (RPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:KUZMA
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 ALLERTON FARMS RD
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-1526
Mailing Address - Country:US
Mailing Address - Phone:203-560-0526
Mailing Address - Fax:
Practice Address - Street 1:89 WEID DR
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4764
Practice Address - Country:US
Practice Address - Phone:203-279-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist