Provider Demographics
NPI:1649392531
Name:PERKOWSKI, KRISTEN EDITH (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:EDITH
Last Name:PERKOWSKI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TARNSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-2361
Mailing Address - Country:US
Mailing Address - Phone:609-267-4770
Mailing Address - Fax:
Practice Address - Street 1:1 MEDFORD LEAS
Practice Address - Street 2:PHYSICAL THERAPY DEPT.
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2254
Practice Address - Country:US
Practice Address - Phone:609-654-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01028800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist