Provider Demographics
NPI:1730607326
Name:IERACE, KATHLEEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:IERACE
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:ESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 E 32ND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5595
Mailing Address - Country:US
Mailing Address - Phone:646-973-5427
Mailing Address - Fax:212-379-2123
Practice Address - Street 1:111 WASHINGTON ST FL 2
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-7796
Practice Address - Country:US
Practice Address - Phone:201-808-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041799-1225100000X
NJ40QA02028800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist