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NPI Code Detail

MEDICARE: KATHLEEN HENTSCHEL PTA

MEDICARE:   KATHLEEN  HENTSCHEL  PTA
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
1225200000XPhysical Therapy Assistant40QB00226700NJ

General Provider Information

NPI Number : 1285759050
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN HENTSCHEL PTA
Provider Business Mailing Address
First Line : 1275 STATE ROUTE 42
Second Line :
City : SPARROW BUSH
State : NY
Zip : 12780-5015
Country : US
Telephone Number : 845-858-4626
Fax Number :
Provider Business Practice Location Address
First Line : 1275 STATE ROUTE 42
Second Line :
City : SPARROW BUSH
State : NY
Zip : 12780-5015
Country : US
Telephone Number : 845-858-4626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN HENTSCHEL PTA” Practice Location

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