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NPI Code Detail

MEDICARE: MRS. KATHLEEN BETH GRAZIANO OTR/L

MEDICARE: MRS. KATHLEEN BETH GRAZIANO OTR/L
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
1225X00000XOccupational Therapist46TR00140500NJ

General Provider Information

NPI Number : 1417145269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN BETH GRAZIANO OTR/L
Provider Business Mailing Address
First Line : 330 MAIN ST
Second Line :
City : CHATHAM
State : NJ
Zip : 07928-2238
Country : US
Telephone Number : 973-635-0224
Fax Number : 973-635-9609
Provider Business Practice Location Address
First Line : 330 MAIN ST
Second Line :
City : CHATHAM
State : NJ
Zip : 07928-2238
Country : US
Telephone Number : 973-635-0224
Fax Number : 973-635-9609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2007
Last Update Date : 10/05/2007

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