MEDICARE: KAITLIN VANDERHOFF

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	104100000X	Social Worker	44SL06091500	NJ

General Provider Information

NPI Number	:	1407383144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN VANDERHOFF

Provider Business Mailing Address
First Line	:	810 RUE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2951
Country	:	US
Telephone Number	:	201-704-4681
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 RUE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2951
Country	:	US
Telephone Number	:	201-704-4681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	01/15/2025

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