Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 020739 | NY |
Y | 225700000X | Massage Therapist | 020739 | NY |
NPI | 1093833378 |
---|---|
Provider Name | Ms. Katherine Signorelli |
First Address | Baldwin, NY 11510-4451 |
Second Address | East Meadow, NY 11554-1107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 20/07/2021 |