Provider Demographics
NPI:1548495237
Name:ASBJORN, KYRSTEN MARIA (ATC)
Entity type:Individual
Prefix:MS
First Name:KYRSTEN
Middle Name:MARIA
Last Name:ASBJORN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-3312
Mailing Address - Country:US
Mailing Address - Phone:732-278-8438
Mailing Address - Fax:
Practice Address - Street 1:1245 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-3312
Practice Address - Country:US
Practice Address - Phone:732-278-8438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0044672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer