Basic Information
Provider Information
NPI: 1538204151
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REIFF
FirstName: KATHLEEN
MiddleName: R.
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 RIVER RD
Address2: SUITE 100
City: CONSHOHOCKEN
State: PA
PostalCode: 194282439
CountryCode: US
TelephoneNumber: 8003553818
FaxNumber: 6108342862
Practice Location
Address1: 1140 ROUTE 72 W
Address2:  
City: MANAHAWKIN
State: NJ
PostalCode: 080502412
CountryCode: US
TelephoneNumber: 6099788900
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/21/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X26N008634100NJY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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