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NPI 1003077314

NPI 1003077314 : EILEEN M KAST PT, OCS : PRINCETON, NJ

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General NPI Number Information
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    NPI Number           |    1003077314
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    Entity Type          |    Individual 
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    Provider Name        |    EILEEN M KAST PT, OCS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/19/2008
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    Last Update Date     |    06/19/2008
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Provider Practice Location Address
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    Address Line         |    26C CHICOPEE DR 
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    City                 |    PRINCETON
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    State                |    NJ
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    Zip                  |    08540-1714
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    Country              |    US
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    Telephone            |    609-454-0025
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26C CHICOPEE DR 
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    City                 |    PRINCETON
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    State                |    NJ
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    Zip                  |    08540-1714
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    Country              |    US
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    Telephone            |    609-454-0025
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    40QA00596300
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    License Number State |    NJ
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