Healthcare Provider Details

I. General information

NPI: 1659008787
Provider Name (Legal Business Name): SYDNEY KERN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 W MAIN ST
FREEHOLD NJ
07728-2538
US

IV. Provider business mailing address

1043 W MAIN ST
FREEHOLD NJ
07728-2538
US

V. Phone/Fax

Practice location:
  • Phone: 732-800-9000
  • Fax: 732-840-2088
Mailing address:
  • Phone: 732-800-9000
  • Fax: 732-840-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305216866
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number29750
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT030650
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02330700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: