Provider Demographics
NPI:1003077314
Name:KAST, EILEEN M (PT, OCS)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:KAST
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26C CHICOPEE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1714
Mailing Address - Country:US
Mailing Address - Phone:609-454-0025
Mailing Address - Fax:
Practice Address - Street 1:26C CHICOPEE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1714
Practice Address - Country:US
Practice Address - Phone:609-454-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA005963002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic