Provider Demographics
NPI:1609076652
Name:KRYJER, EDWARD JAMES (OTR)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JAMES
Last Name:KRYJER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1541
Mailing Address - Country:US
Mailing Address - Phone:609-839-0163
Mailing Address - Fax:
Practice Address - Street 1:1914 WEST AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1541
Practice Address - Country:US
Practice Address - Phone:609-625-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00137200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMEDICARE PINMedicare PIN