Provider Demographics
NPI:1962703470
Name:NAGLE-LAULETTA, KATHLEEN (PT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:NAGLE-LAULETTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 SUNLIT DR
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6225
Mailing Address - Country:US
Mailing Address - Phone:908-756-7708
Mailing Address - Fax:
Practice Address - Street 1:1633 ROUTE 22
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-6505
Practice Address - Country:US
Practice Address - Phone:908-754-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00670200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist