Provider Demographics
NPI:1659044634
Name:MARYKATE HORRIGAN, LLC
Entity Type:Organization
Organization Name:MARYKATE HORRIGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYKATE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORRIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-275-1860
Mailing Address - Street 1:84 MONTCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4131
Mailing Address - Country:US
Mailing Address - Phone:973-275-1860
Mailing Address - Fax:
Practice Address - Street 1:84 MONTCLAIR AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4131
Practice Address - Country:US
Practice Address - Phone:973-275-1860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty