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General NPI Number Information
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NPI Number | 1962703470
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Entity Type | Individual
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Provider Name | KATHLEEN NAGLE-LAULETTA P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 1633 ROUTE 22
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City | WATCHUNG
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State | NJ
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Zip | 07069-6505
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Country | US
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Telephone | 908-754-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 222 SUNLIT DR
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City | WATCHUNG
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State | NJ
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Zip | 07069-6225
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Country | US
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Telephone | 908-756-7708
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00670200
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License Number State | NJ
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