MEDICARE: KASMONE WILLIAMS CAT-LP

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
1	221700000X	Art Therapist	113769	NY

General Provider Information

NPI Number	:	1023762135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASMONE WILLIAMS CAT-LP

Provider Business Mailing Address
First Line	:	2305 2ND AVE APT 25
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-4115
Country	:	US
Telephone Number	:	254-392-3847
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 SYLVIA ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3723
Country	:	US
Telephone Number	:	254-392-3847
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	02/08/2022

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Directions to “ KASMONE WILLIAMS CAT-LP” Practice Location

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