Provider Demographics
NPI:1861464240
Name:KASCAK, THOMAS R (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:R
Last Name:KASCAK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-866-5458
Mailing Address - Fax:203-354-6182
Practice Address - Street 1:5151 PARK AVE
Practice Address - Street 2:SACRED HEART UNIV. & SPORTS MED. CENTER
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1023
Practice Address - Country:US
Practice Address - Phone:203-396-8181
Practice Address - Fax:203-396-8137
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist