Provider Demographics
NPI:1538499009
Name:KONES, KIMBERLY SUSAN (OTR)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUSAN
Last Name:KONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:SUSAN
Other - Last Name:ABRAMSOHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:1 JOHANNA LANE
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069
Mailing Address - Country:US
Mailing Address - Phone:908-769-4192
Mailing Address - Fax:
Practice Address - Street 1:12-22 WOODLAND AVENUE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:973-731-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTR002496225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics