Provider Demographics
NPI:1710351283
Name:BERRIGAN, KATHLEEN (DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:BERRIGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 SPRING GARDEN ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3865
Mailing Address - Country:US
Mailing Address - Phone:510-325-4443
Mailing Address - Fax:
Practice Address - Street 1:1515 THE FAIRWAY
Practice Address - Street 2:
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1435
Practice Address - Country:US
Practice Address - Phone:215-885-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-21
Last Update Date:2015-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA024536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist