Provider Demographics
NPI:1306223334
Name:KAMAI, CECILIA (PTA)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:KAMAI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 47TH ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4078
Mailing Address - Country:US
Mailing Address - Phone:201-978-6532
Mailing Address - Fax:
Practice Address - Street 1:864 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3054
Practice Address - Country:US
Practice Address - Phone:201-339-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
NJ40QB00261700225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty