Provider Demographics
NPI:1811287071
Name:LLOYD, KRISTEN BETH (PTA)
Entity type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:BETH
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NORTHSIDE PIERS
Mailing Address - Street 2:17C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3182
Mailing Address - Country:US
Mailing Address - Phone:917-757-7542
Mailing Address - Fax:
Practice Address - Street 1:421 W CHEW ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3406
Practice Address - Country:US
Practice Address - Phone:917-757-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE008930225200000X
NY007132-1225200000X
MEPA3713225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant