MEDICARE: KINESIOCARE PHYSICAL THERAPY

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1225512338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINESIOCARE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	315 FORSGATE DR
Second Line	:
City	:	MONROE TWP
State	:	NJ
Zip	:	08831-1539
Country	:	US
Telephone Number	:	732-485-5221
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 FORSGATE DR
Second Line	:
City	:	MONROE
State	:	NJ
Zip	:	08831-1539
Country	:	US
Telephone Number	:	732-485-5221
Fax Number	:

Authorized Official
Title or Position	:	DPT
Name	:	KAREN KONDOS ELIAS
Credential	:
Telephone Number	:	609-395-9955

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	01/04/2022

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