Provider Demographics
NPI:1609072420
Name:KAFKA, DANIA MIRIAM (MS, PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIA
Middle Name:MIRIAM
Last Name:KAFKA
Suffix:
Gender:F
Credentials:MS, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MACOPIN DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2913
Mailing Address - Country:US
Mailing Address - Phone:646-734-8361
Mailing Address - Fax:
Practice Address - Street 1:10 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1417
Practice Address - Country:US
Practice Address - Phone:973-400-9301
Practice Address - Fax:973-404-8842
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026464225100000X
NJ40QA01562300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W9Y1Medicare PIN