Provider Demographics
NPI:1326383613
Name:ROSKO, KATHERINE (LAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ROSKO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1353 GLASCO TPKE
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-3219
Mailing Address - Country:US
Mailing Address - Phone:917-539-2306
Mailing Address - Fax:845-684-2454
Practice Address - Street 1:276 TINKER ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1129
Practice Address - Country:US
Practice Address - Phone:917-539-2306
Practice Address - Fax:845-684-2454
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY004858-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist