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General NPI Number Information
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NPI Number | 1861075392
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Entity Type | Individual
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Provider Name | KATHRYN JULIA BACCI
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Gender | Female
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1 RIVERVIEW PLZ
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City | RED BANK
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State | NJ
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Zip | 07701-1864
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Country | US
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Telephone | 732-741-2700
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Fax | 732-398-6405
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Provider Business Mailing Address
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Address Line | 2 CROSSWICKS RD
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City | FREEHOLD
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State | NJ
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Zip | 07728-3009
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Country | US
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Telephone | 908-217-5681
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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