MEDICARE: MR. MATTHEW L KATCHER LMT, LAC

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	171100000X	Acupuncturist	004929	NY
2	225700000X	Massage Therapist	014016	NY

General Provider Information

NPI Number	:	1629498837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW L KATCHER LMT, LAC

Provider Business Mailing Address
First Line	:	55 MONROE BLVD
Second Line	:	APT 3B
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4344
Country	:	US
Telephone Number	:	516-850-4894
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 MONROE BLVD
Second Line	:	APT 3B
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4344
Country	:	US
Telephone Number	:	516-850-4894
Fax Number	:

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

Provider Enumeration Date	:	04/27/2014
Last Update Date	:	04/27/2014

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