MEDICARE: KINDER GROWTH PENN LLC

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1508705641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDER GROWTH PENN LLC

Provider Business Mailing Address
First Line	:	3 MOET CT
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-3090
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 MOET CT
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-3090
Country	:	US
Telephone Number	:	973-405-4707
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARI LEVIN
Credential	:
Telephone Number	:	973-405-4707

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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Directions to “KINDER GROWTH PENN LLC ” Practice Location

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