Provider Demographics
NPI:1124230255
Name:ALBANY, KATHLEEN (PT, MPH)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ALBANY
Suffix:
Gender:F
Credentials:PT, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRAMBLE LANE
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3801
Mailing Address - Country:US
Mailing Address - Phone:732-583-8892
Mailing Address - Fax:732-583-8892
Practice Address - Street 1:141 BODMAN PLACE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-693-0445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00681700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist