Provider Demographics
NPI:1144421827
Name:KLINGER, EDITH A (MS, OTR)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:A
Last Name:KLINGER
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:WARETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08758-2426
Mailing Address - Country:US
Mailing Address - Phone:717-903-1711
Mailing Address - Fax:732-612-1066
Practice Address - Street 1:1228 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4811
Practice Address - Country:US
Practice Address - Phone:717-903-1711
Practice Address - Fax:732-612-1066
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00404100225X00000X
VA0119004200225X00000X
PAOC007427L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist