Provider Demographics
NPI:1093833378
Name:SIGNORELLI, KATHERINE (LMT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:SIGNORELLI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:SIGNORELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:2901 BAYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4451
Mailing Address - Country:US
Mailing Address - Phone:516-342-3422
Mailing Address - Fax:516-544-2690
Practice Address - Street 1:42 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1107
Practice Address - Country:US
Practice Address - Phone:516-414-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020739175F00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175F00000XOther Service ProvidersNaturopath