Active NPI
Kimberly Lorraine Tetro
- Speech-Language Pathologist
- Hamilton, NJ
National Provider Identifier
1740625474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS00702200
- Practice address
- 3575 Quakerbridge Rd
Hamilton, NJ 08619-1271 - Phone
- (609) 631-2800
- NPI assigned
- May 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 41YS00702200 | NJ | Primary |
Addresses
Primary practice location
3575 Quakerbridge Rd
Hamilton, NJ 08619-1271
Mailing address
3575 Quakerbridge Rd
Hamilton, NJ 08619-1271
Phone (609) 631-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41YS00702200 | Other | NJ | SPEECH LANGUAGE PATHOLOGIST |
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 |
|---|---|---|---|
| 41YS00702200 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1740625474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3575 QUAKERBRIDGE RD",
"city": "HAMILTON",
"state": "NJ",
"postal_code": "086191271",
"telephone_number": "609-631-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 QUAKERBRIDGE RD",
"city": "HAMILTON",
"state": "NJ",
"postal_code": "086191271",
"telephone_number": "609-631-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETRO",
"first_name": "KIMBERLY",
"middle_name": "LORRAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-08",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00702200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGUAGE PATHOLOGIST",
"identifier": "41YS00702200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.