Provider Demographics
NPI:1285181644
Name:REIFF, KAITLYN ANN (APN)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:REIFF
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PROSPER WAY UNIT 305
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-3541
Mailing Address - Country:US
Mailing Address - Phone:908-489-2578
Mailing Address - Fax:
Practice Address - Street 1:100 HWY 36 STE 1A
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1453
Practice Address - Country:US
Practice Address - Phone:732-229-6200
Practice Address - Fax:732-229-6201
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ0066600363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care