| Kdr Services, Llc | |
|
22 Gordon Ave Lawrence Township NJ 08648-1033 | |
| (609) 844-0452 | |
| Not Available |
| Full Name | Kdr Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 22 Gordon Ave, Lawrence Township, New Jersey |
| Authorized Official Name and Position | Kristina Rago Solomita (OWNER) |
| Authorized Official Contact | 6098440452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdr Services, Llc Po Box 6573 Lawrence Township NJ 08648-0573 Ph: (609) 844-0452 | Kdr Services, Llc 22 Gordon Ave Lawrence Township NJ 08648-1033 Ph: (609) 844-0452 |
| NPI Number | 1023473238 |
|---|---|
| Provider Enumeration Date | 12/15/2015 |
| Last Update Date | 01/28/2016 |
| Medicare PECOS PAC ID | 5294037321 |
|---|---|
| Medicare Enrollment ID | O20160107000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023473238 | NPI | - | NPPES |
| 1023473238 | Other | NJ | MEDICARE NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05537300 (New Jersey) | Primary |
| Provider Name | Kristina Rago-solomita |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225347123 PECOS PAC ID: 4284868845 Enrollment ID: I20131015000028 |
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