Provider Demographics
NPI:1447543046
Name:CAMOSCIO, KATHERINE (DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CAMOSCIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DOROTHY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887
Mailing Address - Country:US
Mailing Address - Phone:781-789-5207
Mailing Address - Fax:
Practice Address - Street 1:20 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3178
Practice Address - Country:US
Practice Address - Phone:603-822-4500
Practice Address - Fax:603-882-4545
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH37732251P0200X
222Q00000X
MA195642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist