Provider Demographics
NPI:1114526639
Name:HUSSEY, KATHRYN MARY (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARY
Last Name:HUSSEY
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 1:23 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1662
Mailing Address - Country:US
Mailing Address - Phone:732-610-2327
Mailing Address - Fax:
Practice Address - Street 1:10 PARSONAGE RD STE 500
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2475
Practice Address - Country:US
Practice Address - Phone:732-494-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01942500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist