MEDICARE: KATHARINE ANN MOSER OTR

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	225X00000X	Occupational Therapist	013248-1	NY

General Provider Information

NPI Number	:	1295893675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE ANN MOSER OTR

Provider Business Mailing Address
First Line	:	460 W WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3133
Country	:	US
Telephone Number	:	917-232-0862
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 W WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3133
Country	:	US
Telephone Number	:	917-232-0862
Fax Number	:

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	04/23/2020

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Directions to “ KATHARINE ANN MOSER OTR” Practice Location

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