Provider Demographics
NPI:1043764848
Name:BERNZ, KAITLYN MARIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:MARIE
Last Name:BERNZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 GRAND PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2114
Mailing Address - Country:US
Mailing Address - Phone:914-438-9548
Mailing Address - Fax:
Practice Address - Street 1:30 CHURCH HILL RD STE 2
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1658
Practice Address - Country:US
Practice Address - Phone:203-426-8449
Practice Address - Fax:203-426-8980
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040410225100000X
CT011248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist