Provider Demographics
NPI:1801613021
Name:CARRIER, KRISTEN (DPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CARRIER
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 1:55 SCHANCK RD STE A-2
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2979
Mailing Address - Country:US
Mailing Address - Phone:732-303-1575
Mailing Address - Fax:
Practice Address - Street 1:55 SCHANCK RD STE A-2
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2979
Practice Address - Country:US
Practice Address - Phone:732-303-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02075600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist