Provider Demographics
NPI:1396032744
Name:KILKENNY, ERIN LYNN (DPT, PT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNN
Last Name:KILKENNY
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1003 EASTON RD
Mailing Address - Street 2:105 CHATEAU
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2027
Mailing Address - Country:US
Mailing Address - Phone:215-659-7759
Mailing Address - Fax:245-659-6658
Practice Address - Street 1:1003 EASTON RD
Practice Address - Street 2:105 CHATEAU
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2027
Practice Address - Country:US
Practice Address - Phone:215-659-7759
Practice Address - Fax:245-659-6658
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA225786RB2Medicare UPIN