MEDICARE: KATHLEEN R REIFF RNFA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WR0006X	Registered Nurse First Assistant	26NO08634100	NJ

General Provider Information

NPI Number	:	1376701482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHLEEN R REIFF RNFA LLC

Provider Business Mailing Address
First Line	:	404 ENGLESIDE AVE
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-1729
Country	:	US
Telephone Number	:	609-207-1320
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 ENGLESIDE AVE
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-1729
Country	:	US
Telephone Number	:	609-207-1320
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. KATHLEEN RUTH REIFF
Credential	:	RNFA
Telephone Number	:	609-207-1320

Provider Enumeration Date	:	05/26/2008
Last Update Date	:	05/26/2008

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