Provider Demographics
NPI:1922790112
Name:SIROLLI, KIMBERLY
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SIROLLI
Suffix:
Gender:F
Credentials:
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:TUCKERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-0510
Mailing Address - Country:US
Mailing Address - Phone:609-296-0440
Mailing Address - Fax:609-812-5112
Practice Address - Street 1:7 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TUCKERTON
Practice Address - State:NJ
Practice Address - Zip Code:08087-2615
Practice Address - Country:US
Practice Address - Phone:609-296-0440
Practice Address - Fax:609-812-5112
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist