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General NPI Number Information
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NPI Number | 1285327486
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Entity Type | Individual
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Provider Name | KATIE MAE FIELDS
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Gender | Female
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 99 KINDERKAMACK RD STE 100
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City | WESTWOOD
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State | NJ
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Zip | 07675-3012
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Country | US
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Telephone | 201-383-0826
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Fax | 201-383-0988
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Provider Business Mailing Address
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Address Line | 99 KINDERKAMACK RD STE 100
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City | WESTWOOD
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State | NJ
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Zip | 07675-3012
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Country | US
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Telephone | 201-383-0826
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Fax | 201-383-0988
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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 | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 40QA02174500
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License Number State | NJ
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