Provider Demographics
NPI:1073147419
Name:OREJUELA, KIMBERLYN STEPHNY
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:STEPHNY
Last Name:OREJUELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 1/2 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-1714
Mailing Address - Country:US
Mailing Address - Phone:484-426-0659
Mailing Address - Fax:
Practice Address - Street 1:403 1/2 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-1714
Practice Address - Country:US
Practice Address - Phone:484-426-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program