Provider Demographics
NPI:1225796675
Name:KALINOSKI, STEPHEN RICHARD (DPT)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:KALINOSKI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 KINGFISHER DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-3234
Mailing Address - Country:US
Mailing Address - Phone:732-939-5114
Mailing Address - Fax:
Practice Address - Street 1:3276 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1676
Practice Address - Country:US
Practice Address - Phone:732-238-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02060300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist