Provider Demographics
NPI:1558470211
Name:CALDARELLA, KRISTIN M (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:M
Last Name:CALDARELLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 PATTERSON AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4166
Mailing Address - Country:US
Mailing Address - Phone:732-842-6600
Mailing Address - Fax:
Practice Address - Street 1:22 LONGVIEW WAY
Practice Address - Street 2:
Practice Address - City:SEA BRIGHT
Practice Address - State:NJ
Practice Address - Zip Code:07760-2217
Practice Address - Country:US
Practice Address - Phone:201-926-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA007091002251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics