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General NPI Number Information
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NPI Number | 1578292934
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Entity Type | Individual
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Provider Name | KATHRYN MARY LEDERER DC
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 7000 BOULEVARD E STE M-9
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City | GUTTENBERG
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State | NJ
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Zip | 07093-4825
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Country | US
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Telephone | 201-305-3591
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | BUDD LAKE
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State | NJ
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Zip | 07828-0252
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Country | US
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Telephone | 908-399-1600
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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 | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 38MC00790400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 38MC00790400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | 38MC00790400
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00790400
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License Number State | NJ
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