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NPI Code Detail

MEDICARE: DR. KAITLYN MARIE BERNZ PT, DPT

MEDICARE: DR. KAITLYN MARIE BERNZ PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist040410NY
2225100000XPhysical Therapist011248CT

General Provider Information

NPI Number : 1043764848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAITLYN MARIE BERNZ PT, DPT
Provider Business Mailing Address
First Line : 36 GRAND PL
Second Line :
City : NEWTOWN
State : CT
Zip : 06470-2114
Country : US
Telephone Number : 914-438-9548
Fax Number :
Provider Business Practice Location Address
First Line : 30 CHURCH HILL RD STE 2
Second Line :
City : NEWTOWN
State : CT
Zip : 06470-1658
Country : US
Telephone Number : 203-426-8449
Fax Number : 203-426-8980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2016
Last Update Date : 07/20/2022

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