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General NPI Number Information
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NPI Number | 1326383613
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Entity Type | Individual
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Provider Name | KATHERINE ROSKO LAC
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Gender | Female
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 276 TINKER ST
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City | WOODSTOCK
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State | NY
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Zip | 12498-1129
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Country | US
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Telephone | 917-539-2306
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Fax | 845-684-2454
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Provider Business Mailing Address
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Address Line | 1353 GLASCO TPKE
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City | SAUGERTIES
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State | NY
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Zip | 12477-3219
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Country | US
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Telephone | 917-539-2306
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Fax | 845-684-2454
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 004858-1
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License Number State | NY
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