MEDICARE: KATHERINE I WALSH P.T.

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	225100000X	Physical Therapist	015060-1	NY

General Provider Information

NPI Number	:	1215062443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE I WALSH P.T.

Provider Business Mailing Address
First Line	:	149 COUNTY ROUTE 38
Second Line	:
City	:	HASTINGS
State	:	NY
Zip	:	13076-3180
Country	:	US
Telephone Number	:	315-676-4498
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 COUNTY ROUTE 38
Second Line	:
City	:	HASTINGS
State	:	NY
Zip	:	13076-3180
Country	:	US
Telephone Number	:	315-676-4498
Fax Number	:

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/08/2007

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