Provider Demographics
NPI:1912746801
Name:SILVER, KATHRYN (PTA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:SILVER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 MANAPAQUA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08733-2602
Mailing Address - Country:US
Mailing Address - Phone:732-927-0750
Mailing Address - Fax:
Practice Address - Street 1:4253 US 9 BLDG 4
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8309
Practice Address - Country:US
Practice Address - Phone:732-780-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00335900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist