Basic Information
| Provider Information | |||||||||
| NPI: | 1124450689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RENDALL | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | CHIUSANO | ||||||||
| OtherFirstName: | KATHERINE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 120 W GERMANTOWN PIKE STE 100 | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194621420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102700370 | ||||||||
| FaxNumber: | 6102700374 | ||||||||
| Practice Location | |||||||||
| Address1: | 300A PRINCETON - HIGHTSTOWN ROAD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | EAST WINDSOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085209998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094264442 | ||||||||
| FaxNumber: | 6094430910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2013 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01498500 | NJ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.