Provider Demographics
NPI:1003800574
Name:KIRSCH, NANCY R (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:R
Last Name:KIRSCH
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 1:14 MONHEGON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1808
Mailing Address - Country:US
Mailing Address - Phone:973-627-4283
Mailing Address - Fax:
Practice Address - Street 1:272 ROUTE 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9081
Practice Address - Country:US
Practice Address - Phone:973-927-3034
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28901OtherCIGNA
NJ577729Medicare ID - Type Unspecified