Provider Demographics
NPI:1407805179
Name:KEMISH, JASON A (MSPT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:A
Last Name:KEMISH
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
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Mailing Address - Street 1:506 CROMWELL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1851
Mailing Address - Country:US
Mailing Address - Phone:860-721-9801
Mailing Address - Fax:860-721-8475
Practice Address - Street 1:506 CROMWELL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1851
Practice Address - Country:US
Practice Address - Phone:860-721-9801
Practice Address - Fax:860-721-8475
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT7848225100000X, 2251G0304X, 2251N0400X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT36401OtherCIGNA HEALTHCARE
CT0036401OtherPRIVATE HEALTHCARE SYSTEMS
CTANC1648OtherOXFORD HEALTHCARE
CT06-1090356OtherJASON A. KEMISH. MSPT
CT7848OtherJASON A. KEMISH, MSPT
CT015353OtherCONNECTICARE
CT2V8222OtherHEALTHNET
CT623570OtherTUFTS HEALTHCARE
CT080007848CT01OtherANTHEM BLUE CROSS AND BLUE SHIED
CT119457OtherAETNA
CT650001317Medicare PIN