Provider Demographics
NPI:1245058403
Name:COMESANAS, KAITLYN DANIELLE
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:DANIELLE
Last Name:COMESANAS
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 1:884 DEGRAW AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1709
Mailing Address - Country:US
Mailing Address - Phone:973-986-7910
Mailing Address - Fax:
Practice Address - Street 1:80 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5460
Practice Address - Country:US
Practice Address - Phone:973-986-7910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health