Provider Demographics
NPI:1053438416
Name:KAMINSKI, KATHLEEN JEAN (PTA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JEAN
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2248 OCHRE ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-1910
Mailing Address - Country:US
Mailing Address - Phone:610-779-0600
Mailing Address - Fax:610-370-2185
Practice Address - Street 1:5501 PERKIOMEN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3633
Practice Address - Country:US
Practice Address - Phone:610-779-0600
Practice Address - Fax:610-370-2185
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE002308L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant