Provider Demographics
NPI:1568694461
Name:OLEWNIK, CARRIE B (PT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:B
Last Name:OLEWNIK
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 1:158 STATE ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-3202
Mailing Address - Country:US
Mailing Address - Phone:203-237-7835
Mailing Address - Fax:203-237-9187
Practice Address - Street 1:158 STATE ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-3202
Practice Address - Country:US
Practice Address - Phone:203-237-7835
Practice Address - Fax:203-237-9187
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist