Provider Demographics
NPI:1649310087
Name:KUIKEN, KIMBERLY ANNE (PT)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:KUIKEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 WALL ROAD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762
Mailing Address - Country:US
Mailing Address - Phone:732-682-3166
Mailing Address - Fax:
Practice Address - Street 1:420 ROUTE 34 STE 317
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2517
Practice Address - Country:US
Practice Address - Phone:732-252-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00858100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist