Provider Demographics
NPI:1497387112
Name:GLUSZEK, KATHERINE WALTON (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WALTON
Last Name:GLUSZEK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:119 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3138
Mailing Address - Country:US
Mailing Address - Phone:315-506-5080
Mailing Address - Fax:
Practice Address - Street 1:50 W ACADEMY ST
Practice Address - Street 2:
Practice Address - City:MC GRAW
Practice Address - State:NY
Practice Address - Zip Code:13101-9424
Practice Address - Country:US
Practice Address - Phone:607-836-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02423901225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics