Active NPI
Kathleen A Opromollo
- Physical Therapist
- Newark, NJ
National Provider Identifier
1124241815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00168800
- Practice address
- 150 Bergen St
University Hospital B403
Newark, NJ 07103-2496 - Phone
- (973) 972-3282
- Fax
- (973) 972-5725
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00168800 | NJ | Primary |
Addresses
Primary practice location
150 Bergen St
University Hospital B403
Newark, NJ 07103-2496
Mailing address
811 Park Rd
Morris Plains, NJ 07950-2848
Phone (973) 539-9713
Other names 1
- Ms. Kathleen A King
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00168800 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124241815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 PARK RD",
"city": "MORRIS PLAINS",
"state": "NJ",
"postal_code": "079502848",
"telephone_number": "973-539-9713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 BERGEN ST",
"address_2": "UNIVERSITY HOSPITAL B403",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032496",
"telephone_number": "973-972-3282",
"fax_number": "973-972-5725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPROMOLLO",
"first_name": "KATHLEEN",
"middle_name": "A",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00168800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "KING",
"middle_name": "A",
"prefix": "MS.",
"credential": "PT",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.