Provider Demographics
NPI:1174863153
Name:KARDOS, KAITLYN (OTR)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:KARDOS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:BURGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 EAGLE ROCK AVE.
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:6612-18 BERGEBLINE AVE.
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093
Practice Address - Country:US
Practice Address - Phone:201-854-5511
Practice Address - Fax:201-854-5522
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00605100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist