Provider Demographics
NPI:1225660897
Name:KILKUSKIE, KEVIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:KILKUSKIE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2234
Mailing Address - Country:US
Mailing Address - Phone:907-538-4997
Mailing Address - Fax:
Practice Address - Street 1:321 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2234
Practice Address - Country:US
Practice Address - Phone:907-538-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist