Healthcare Provider Details

I. General information

NPI: 1972159374
Provider Name (Legal Business Name): KATHERINE ROSE GIBLIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE CROWE PT

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAMARONECK AVE
HARRISON NY
10528-1633
US

IV. Provider business mailing address

5 HIGH RIDGE PARK FL 2
STAMFORD CT
06905-1332
US

V. Phone/Fax

Practice location:
  • Phone: 203-869-1145
  • Fax: 203-618-1721
Mailing address:
  • Phone: 203-869-1145
  • Fax: 203-618-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number043874
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: