Provider Demographics
NPI:1821670209
Name:PANNONE, KRISTI (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:PANNONE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-0510
Mailing Address - Country:US
Mailing Address - Phone:609-276-2326
Mailing Address - Fax:609-812-5112
Practice Address - Street 1:1 LEIFRIED LN STE A
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-2000
Practice Address - Country:US
Practice Address - Phone:609-296-0440
Practice Address - Fax:609-812-5112
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00986500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty