Active NPI
Kristine Kreutzer
- Speech-Language Pathologist
- Wall Township, NJ
National Provider Identifier
1215214697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS00631600
- Practice address
- 3349 Highway 138
Building B, Suite a
Wall Township, NJ 07719-9671 - Phone
- (732) 280-6050
- NPI assigned
- Nov 13, 2011
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS00631600 | NJ | Primary |
Addresses
Primary practice location
3349 Highway 138
Building B, Suite a
Wall Township, NJ 07719-9671
Mailing address
12 Lebanon Dr
Brielle, NJ 08730-1546
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 |
|---|---|---|---|
| 41YS00631600 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359158400000",
"number": "1215214697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 LEBANON DR",
"city": "BRIELLE",
"state": "NJ",
"postal_code": "087301546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3349 HIGHWAY 138",
"address_2": "BUILDING B, SUITE A",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077199671",
"telephone_number": "732-280-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREUTZER",
"first_name": "KRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-13",
"last_updated": "2013-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00631600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wall Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.