Provider Demographics
NPI:1104189141
Name:FLAMINI, KRISTEN M
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:M
Last Name:FLAMINI
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 1:1330 E KINGS HWY
Mailing Address - Street 2:APT. 2208
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-2055
Mailing Address - Country:US
Mailing Address - Phone:856-296-0863
Mailing Address - Fax:
Practice Address - Street 1:1330 E KINGS HWY
Practice Address - Street 2:APT. 2208
Practice Address - City:MAPLE SHADE
Practice Address - State:NJ
Practice Address - Zip Code:08052-2055
Practice Address - Country:US
Practice Address - Phone:856-296-0863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist