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General NPI Number Information
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NPI Number | 1134354582
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Entity Type | Individual
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Provider Name | KATHERINE COTE GLEASON DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 138 RIVER RD STE 101
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City | ANDOVER
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State | MA
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Zip | 01810
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Country | US
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Telephone | 978-289-6108
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Fax | 978-289-6109
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Provider Business Mailing Address
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Address Line | 576 BROADHOLLOW RD
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City | MELVILLE
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State | NY
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Zip | 11747-5002
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Country | US
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Telephone | 631-359-5859
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Fax | 631-396-0864
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17974
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License Number State | MA
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