Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA01140900 | NJ |
NPI | 1053665141 |
---|---|
Provider Name | Kathy Yoffe |
First Address | Lakewood, NJ 08701-2983 |
Second Address | Lakewood, NJ 08701-2983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2012 |
Last Update Date | 29/10/2012 |