Individual
MR. PHILIP J KIERSTEDT II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
150 EAST LAKE AVE, RAHWAY, NJ 07065
(212) 360-7183
Mailing address
150 E LAKE AVE, RAHWAY, NJ 07065-4919
(212) 360-7116
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
16873
NY
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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