Provider Demographics
NPI:1841903994
Name:DY, KATRINA A (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:A
Last Name:DY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-1766
Mailing Address - Country:US
Mailing Address - Phone:732-501-1625
Mailing Address - Fax:
Practice Address - Street 1:515 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-1766
Practice Address - Country:US
Practice Address - Phone:732-326-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01914900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist