Healthcare Provider Details

I. General information

NPI: 1710066238
Provider Name (Legal Business Name): ELIZABETH KULAS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HOSPITAL AVE
DANBURY CT
06810-6007
US

IV. Provider business mailing address

35 MOUNTAIN RD
SEYMOUR CT
06483-2039
US

V. Phone/Fax

Practice location:
  • Phone: 203-792-2164
  • Fax: 203-731-3210
Mailing address:
  • Phone: 203-888-6481
  • Fax: 203-888-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002597
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: