Healthcare Provider Details

I. General information

NPI: 1013383983
Provider Name (Legal Business Name): KERIN NADLER LCAT, BC-DMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PENTHOUSE
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

19 W 34TH ST PENTHOUSE
NEW YORK NY
10001-3006
US

V. Phone/Fax

Practice location:
  • Phone: 917-597-8055
  • Fax:
Mailing address:
  • Phone: 917-597-8055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number001552-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: