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NPI Code Detail

MEDICARE: KATHERINE NELSON

MEDICARE: KATHERINE NELSON
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
1225100000XPhysical Therapist055302NY

General Provider Information

NPI Number : 1750245841
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE NELSON
Provider Business Mailing Address
First Line : 792 N MAIN ST STE 100C
Second Line :
City : NORTH SYRACUSE
State : NY
Zip : 13212-1667
Country : US
Telephone Number : 315-458-2552
Fax Number : 315-458-2575
Provider Business Practice Location Address
First Line : 792 N MAIN ST STE 100C
Second Line :
City : NORTH SYRACUSE
State : NY
Zip : 13212-1667
Country : US
Telephone Number : 315-458-2552
Fax Number : 315-458-2575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ KATHERINE NELSON ” Practice Location

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