Kathleen Fox, PTA

Individual provider Active NPI Physical Therapy Assistant · Shamong, NJ

NPI 1629216320 · NPPES record last updated Feb 3, 2009

Key facts

NPI
1629216320
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
40QB00121100 (NJ)
Practice address
829 McKendimen Rd
Shamong, NJ 08088-8661
Phone
(800) 950-6066
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
40QB00121100NJMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00121100 NJ Yes

Addresses

Primary practice location

829 McKendimen Rd
Shamong, NJ 08088-8661

Mailing address

829 McKendimen Rd
Shamong, NJ 08088-8661
Phone (800) 950-6066

Other providers in Shamong, NJ

All providers in Shamong, NJ · Physical Therapy Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.