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NPI Code Detail

MEDICARE: MRS. KATHLEEN EATON PT

MEDICARE:  MRS. KATHLEEN  EATON  PT
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 Therapist025992-1NY

General Provider Information

NPI Number : 1780859116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN EATON PT
Provider Business Mailing Address
First Line : 16 CAROLINE AVE
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-5742
Country : US
Telephone Number : 516-909-8347
Fax Number :
Provider Business Practice Location Address
First Line : 1156 BOWMAN RD UNIT 105
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-3803
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2008
Last Update Date : 04/07/2025

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Directions to “ MRS. KATHLEEN EATON PT” Practice Location

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