Basic Information
| Provider Information | |||||||||
| NPI: | 1578104543 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABARABAR | ||||||||
| FirstName: | KRISSTOFFER | ||||||||
| MiddleName: | C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1014 | ||||||||
| Address2: | |||||||||
| City: | CLARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070661014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328559751 | ||||||||
| FaxNumber: | 7328559755 | ||||||||
| Practice Location | |||||||||
| Address1: | 1180 RARITAN RD | ||||||||
| Address2: | |||||||||
| City: | CLARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070661311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082762626 | ||||||||
| FaxNumber: | 7328559755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2019 | ||||||||
| LastUpdateDate: | 10/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251E1200X | 40QA01874800 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics |
No ID Information.