Healthcare Provider Details

I. General information

NPI: 1396707741
Provider Name (Legal Business Name): KATHY ROSEN KERR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHY L KERR

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 KILMER DR STE 107
MORGANVILLE NJ
07751-1561
US

IV. Provider business mailing address

379 CAMPUS DR
SOMERSET NJ
08873-1161
US

V. Phone/Fax

Practice location:
  • Phone: 973-714-5496
  • Fax:
Mailing address:
  • Phone: 973-714-5496
  • Fax: 908-757-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA046992
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA046992
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: