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NPI Code Detail

MEDICARE: KATHERINE BOGER LMT

MEDICARE:   KATHERINE  BOGER  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist028009NY

General Provider Information

NPI Number : 1013789320
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BOGER LMT
Provider Business Mailing Address
First Line : 41 W 118TH ST APT 2
Second Line :
City : NEW YORK
State : NY
Zip : 10026-1932
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18 E 41ST ST RM 403
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6257
Country : US
Telephone Number : 646-598-4816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 06/05/2024

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Directions to “ KATHERINE BOGER LMT” Practice Location

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