MEDICARE: KAT BODYTECH, INC

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	2255A2300X	Athletic Trainer
2	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1750123055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAT BODYTECH, INC

Provider Business Mailing Address
First Line	:	41 W 118TH ST APT 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-1932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 E 41ST ST RM 403
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6257
Country	:	US
Telephone Number	:	646-598-4816
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE BOGER
Credential	:	LMT
Telephone Number	:	646-598-4816

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/10/2024

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