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General NPI Number Information
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NPI Number | 1497894828
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Entity Type | Individual
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Provider Name | KATHERINE EDITH GOSMAN PT
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2098 N WADING RIVER RD
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City | WADING RIVER
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State | NY
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Zip | 11792
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Country | US
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Telephone | 631-747-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 2098 N WADING RIVER RD PO BOX 574
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City | WADING RIVER
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State | NY
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Zip | 11792-1400
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Country | US
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Telephone | 631-929-3478
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Fax |
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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 | 019585-1
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License Number State | NY
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