Provider Demographics
NPI:1609121565
Name:KITTS, NATALKA
Entity Type:Individual
Prefix:
First Name:NATALKA
Middle Name:
Last Name:KITTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 MOUNTAIN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838-2348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:380 MOUNTAIN LAKE RD
Practice Address - Street 2:
Practice Address - City:GREAT MEADOWS
Practice Address - State:NJ
Practice Address - Zip Code:07838-2348
Practice Address - Country:US
Practice Address - Phone:908-399-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00576700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist