MEDICARE: MS. KATHERINE SHMIKLER

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
1	225100000X	Physical Therapist	15375	MA
2	225100000X	Physical Therapist	035038	NY

General Provider Information

NPI Number	:	1346491131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE SHMIKLER

Provider Business Mailing Address
First Line	:	2500 JOHNSON AVE APT 20H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-4946
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 JOHNSON AVE APT 20H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-4946
Country	:	US
Telephone Number	:	617-721-8687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	10/29/2021

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