Provider Demographics
NPI:1033353826
Name:HOBAN MITTERWAY, KATE (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:
Last Name:HOBAN MITTERWAY
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 BEACH 130TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1524
Mailing Address - Country:US
Mailing Address - Phone:917-626-4405
Mailing Address - Fax:
Practice Address - Street 1:411 BEACH 130TH ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1524
Practice Address - Country:US
Practice Address - Phone:917-626-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010695-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics