Healthcare Provider Details

I. General information

NPI: 1992867022
Provider Name (Legal Business Name): EDITA KOTES MS, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 US HIGHWAY 9
HOWELL NJ
07731-3380
US

IV. Provider business mailing address

4539 US HIGHWAY 9
HOWELL NJ
07731-3380
US

V. Phone/Fax

Practice location:
  • Phone: 732-901-5553
  • Fax: 732-901-1131
Mailing address:
  • Phone: 732-901-5553
  • Fax: 732-901-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: