Healthcare Provider Details

I. General information

NPI: 1013823848
Provider Name (Legal Business Name): KIRA NICOLE WILLIAMSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 NJ-28 BLDG 1 SUITE 204A
RARITAN NJ
08869
US

IV. Provider business mailing address

575 NJ-28 BLDG 1 SUITE 204A
RARITAN NJ
08869
US

V. Phone/Fax

Practice location:
  • Phone: 908-543-4390
  • Fax:
Mailing address:
  • Phone: 908-543-4390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number40QA02434900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: