Basic Information
| Provider Information | |||||||||
| NPI: | 1326332339 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EFFLER | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | CORRY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4755 OGLETOWN STANTON ROAD | ||||||||
| Address2: | SUITE 6E34 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197182200 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4755 OGLETOWN STANTON ROAD | ||||||||
| Address2: | SUITE 6E34 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197182200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027334186 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 08/01/2016 | ||||||||
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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 | 208100000X | MT200227 | PA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 390200000X | MT200227 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208100000X | C1-0011662 | DE | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.