Provider Demographics
NPI:1427656578
Name:KRATZER, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KRATZER
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 1:200 HUDSON ST STE 127
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07311-1220
Mailing Address - Country:US
Mailing Address - Phone:201-721-6130
Mailing Address - Fax:
Practice Address - Street 1:200 HUDSON ST STE 127
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07311-1220
Practice Address - Country:US
Practice Address - Phone:201-721-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01968600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist