Provider Demographics
NPI:1053784579
Name:DURKIN-KLEIN, JOAN (PTA)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:DURKIN-KLEIN
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 1:527 WRIGHTSTOWN SYKESVILLE RD
Mailing Address - Street 2:BUILDING C, UNIT 15
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08562-1530
Mailing Address - Country:US
Mailing Address - Phone:609-316-0195
Mailing Address - Fax:609-353-1549
Practice Address - Street 1:14500 BUSTLETON AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1188
Practice Address - Country:US
Practice Address - Phone:215-613-6523
Practice Address - Fax:215-613-6527
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00100100225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant