Provider Demographics
NPI:1386685279
Name:ALEKSIEJUK, JOANNA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:ALEKSIEJUK
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 DIXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1860
Mailing Address - Country:US
Mailing Address - Phone:203-248-2400
Mailing Address - Fax:203-248-9778
Practice Address - Street 1:2543 DIXWELL AVENUE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-4028
Practice Address - Country:US
Practice Address - Phone:203-248-2400
Practice Address - Fax:203-248-9778
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT19002OtherCIGNA-ORTHONET
CT20-1237459OtherTAX IDENIFICATION NUMBER
CT080005370CTOtherANTHEM BLUE CROSS
CTP00218724OtherRR MEDICARE
CTP595234OtherOXFORD HEALTHPLAN
CT2V2317OtherHEALTHNET
CT3552074OtherAETNA
CT20-1237459OtherTAX IDENIFICATION NUMBER