Provider Demographics
NPI:1306094495
Name:BRIAR, KAITLIN (MPT)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:BRIAR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:PATRICIA
Other - Last Name:FIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:1161 BURNT TAVERN RD.
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-1472
Practice Address - Country:US
Practice Address - Phone:732-458-1755
Practice Address - Fax:732-458-6408
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01286300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist