Provider Demographics
NPI:1518523323
Name:RICHTER, KATIE A (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:A
Last Name:RICHTER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2538
Mailing Address - Country:US
Mailing Address - Phone:732-800-9000
Mailing Address - Fax:732-840-2088
Practice Address - Street 1:1043 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2538
Practice Address - Country:US
Practice Address - Phone:732-800-9000
Practice Address - Fax:732-840-2088
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023569225X00000X
NJ46TR00873700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ46TR00873700OtherNEW JERSEY DIVISION OF CONSUMER AFFAIRS
NY023569OtherTHE UNIVERSITY OF THE STATE OF NEW YORK