Provider Demographics
NPI:1386268530
Name:TESTA, KAITLYN ANN (DPM)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ANN
Last Name:TESTA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MORRIS AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1020
Mailing Address - Country:US
Mailing Address - Phone:973-376-8210
Mailing Address - Fax:973-258-0415
Practice Address - Street 1:500 MORRIS AVE STE 203
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1020
Practice Address - Country:US
Practice Address - Phone:973-376-8210
Practice Address - Fax:973-258-0415
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00370900213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery