Provider Demographics
NPI:1427378439
Name:KHO, KATHLEEN D
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:D
Last Name:KHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3619
Mailing Address - Country:US
Mailing Address - Phone:973-246-6565
Mailing Address - Fax:973-883-0140
Practice Address - Street 1:1070 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3619
Practice Address - Country:US
Practice Address - Phone:973-246-6565
Practice Address - Fax:973-883-0140
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016126225X00000X
NJ46TR00514000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist