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NPI Code Detail

MEDICARE: KATHERINE PRUDENTE LCAT, RDT

MEDICARE: KATHERINE PRUDENTE LCAT, RDT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1221700000XArt Therapist001210-1NY

General Provider Information

NPI Number : 1265669543
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE PRUDENTE LCAT, RDT
Provider Business Mailing Address
First Line : 16 MADISON SQ W STE 1122
Second Line :
City : NEW YORK
State : NY
Zip : 10010-1629
Country : US
Telephone Number : 917-410-0467
Fax Number :
Provider Business Practice Location Address
First Line : 16 MADISON SQ W STE 1122
Second Line :
City : NEW YORK
State : NY
Zip : 10010-1629
Country : US
Telephone Number : 917-410-0467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2009
Last Update Date : 07/14/2020

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Directions to “ KATHERINE PRUDENTE LCAT, RDT” Practice Location

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