Basic Information
Provider Information
NPI: 1780913848
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOSZKIEWICZ
FirstName: KATHI
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2222 SULLIVAN TRL
Address2:  
City: EASTON
State: PA
PostalCode: 180407958
CountryCode: US
TelephoneNumber: 8009449782
FaxNumber: 6104382024
Practice Location
Address1: 300 RIVERMEAD RD
Address2:  
City: PETERBOROUGH
State: NH
PostalCode: 034581762
CountryCode: US
TelephoneNumber: 6039240062
FaxNumber: 6039247135
Other Information
ProviderEnumerationDate: 12/18/2009
LastUpdateDate: 12/18/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X0178NHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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