Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 40QA01428100 | NJ |
N | 2251X0800X | Physical Therapist - Orthopedic | 40QA01428100 | NJ |
NPI | 1447757638 |
---|---|
Provider Name | Kristina Lagzdins |
First Address | Basking Ridge, NJ 07920-3151 |
Second Address | Edison, NJ 08820-3947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2018 |
Last Update Date | 12/04/2018 |