Provider Demographics
NPI:1093077364
Name:ACKERMAN, KERRY ROBYN (MS)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ROBYN
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 HUDSON STREET
Mailing Address - Street 2:APT 605N
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030
Mailing Address - Country:US
Mailing Address - Phone:917-689-4702
Mailing Address - Fax:
Practice Address - Street 1:1333 HUDSON STREET
Practice Address - Street 2:APT 605N
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030
Practice Address - Country:US
Practice Address - Phone:917-689-4702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist