Healthcare Provider Details

I. General information

NPI: 1467368381
Provider Name (Legal Business Name): KATELYN GENEVIEVE LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CORPORATE BLVD S
YONKERS NY
10701-6862
US

IV. Provider business mailing address

44 ADELE CT
RED BANK NJ
07701-5244
US

V. Phone/Fax

Practice location:
  • Phone: 833-637-3866
  • Fax:
Mailing address:
  • Phone: 917-968-5118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056191
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: