Provider Demographics
NPI:1841480621
Name:POSS, KIMBERLY (RT(R), RPA, RA, RDMS)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:POSS
Suffix:
Gender:F
Credentials:RT(R), RPA, RA, RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 SHENANDOAH AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-5025
Mailing Address - Country:US
Mailing Address - Phone:732-657-9032
Mailing Address - Fax:
Practice Address - Street 1:27 SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759-5025
Practice Address - Country:US
Practice Address - Phone:732-657-9032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ07 NJ 1315243U00000X
NJ381072471V0105X
NJ2312912471C3401X
NJ07NJ13152471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography