Provider Demographics
NPI:1831731348
Name:MERTZ, KERRY (PT)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:MERTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ASMARA WAY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-2150
Mailing Address - Country:US
Mailing Address - Phone:203-232-6993
Mailing Address - Fax:
Practice Address - Street 1:1571 STRATFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1376
Practice Address - Country:US
Practice Address - Phone:203-583-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist