Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 009499-1 | NY |
NPI | 1093941288 |
---|---|
Provider Name | Kathleen Jean Pascatore-Moller |
First Address | Russell, PA 16345-5739 |
Second Address | Russell, PA 16345-5739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2009 |
Last Update Date | 26/08/2015 |