Healthcare Provider Details

I. General information

NPI: 1265616700
Provider Name (Legal Business Name): KATHERYN L GELZER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 PEARL ST
HYANNIS MA
02601-3937
US

IV. Provider business mailing address

1 OLD TOLL RD
WEST BARNSTABLE MA
02668-1301
US

V. Phone/Fax

Practice location:
  • Phone: 508-775-6240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2436
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: