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General NPI Number Information
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NPI Number | 1861945735
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Entity Type | Individual
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Provider Name | KATHLEEN M FORD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 140 E RIDGEWOOD AVE
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City | PARAMUS
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State | NJ
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Zip | 07652-3917
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Country | US
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Telephone | 615-610-7705
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Fax | 833-464-4086
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Provider Business Mailing Address
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Address Line | 558 OAKHOLLOW LN
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City | LANOKA HARBOR
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State | NJ
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Zip | 08734-2130
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Country | US
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Telephone | 610-733-0559
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP0616362
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License Number State | PA
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