Provider Demographics
NPI:1770641946
Name:ADORNEY, KATHRYN MARIE (PH,D)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MARIE
Last Name:ADORNEY
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1820
Mailing Address - Country:US
Mailing Address - Phone:201-444-2248
Mailing Address - Fax:845-255-2943
Practice Address - Street 1:93 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1820
Practice Address - Country:US
Practice Address - Phone:201-444-2248
Practice Address - Fax:845-255-2943
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2124103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJAD665363Medicare ID - Type Unspecified