Provider Demographics
NPI:1356479174
Name:DOBOSZ, KAREN (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DOBOSZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 COMMERCE PARK
Mailing Address - Street 2:SHORELINE PHYSICAL THERAPY & SPORTS MEDICINE
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-876-7316
Mailing Address - Fax:203-876-0041
Practice Address - Street 1:60 COMMERCE PARK
Practice Address - Street 2:SHORELINE PHYSICAL THERAPY & SPORTS MEDICINE
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3506
Practice Address - Country:US
Practice Address - Phone:203-876-7316
Practice Address - Fax:203-876-0041
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTANC1326OtherOXFORD
CTAETNAOther567709
CT080001245CT03OtherBLUE CROSS BLUE SHIELD
CT35501OtherCIGNA
CT061420213OtherUNITED HEALTH CARE
CT2V8297OtherHEALTHNET
CT650000262Medicare ID - Type Unspecified