Provider Demographics
NPI:1457641565
Name:PFISTER, KATHRYN ROSE (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ROSE
Last Name:PFISTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 SIGNAL LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6336
Mailing Address - Country:US
Mailing Address - Phone:732-779-1135
Mailing Address - Fax:
Practice Address - Street 1:506 SIGNAL LN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6336
Practice Address - Country:US
Practice Address - Phone:732-779-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01364000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist