Provider Demographics
NPI:1992306336
Name:KIND RAJU, KAITLYN (DPT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:KIND RAJU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 4A SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-803-2427
Mailing Address - Fax:
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BUILDING 4A SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-803-2427
Practice Address - Fax:609-896-3555
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02082600225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist