Provider Demographics
NPI:1780385286
Name:BAKTIS, KRISTINA (LCAT, LPAT, ATR-BC,)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:BAKTIS
Suffix:
Gender:F
Credentials:LCAT, LPAT, ATR-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 CRUSHER RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2204
Mailing Address - Country:US
Mailing Address - Phone:347-598-4050
Mailing Address - Fax:
Practice Address - Street 1:168 CRUSHER RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-2204
Practice Address - Country:US
Practice Address - Phone:347-598-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2025-09-04
Deactivation Date:2024-04-19
Deactivation Code:
Reactivation Date:2025-09-04
Provider Licenses
StateLicense IDTaxonomies
NJ16LP00007900221700000X
NY001626221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist