Provider Demographics
NPI:1063775336
Name:MOLESPHINI, KATHLEEN (MS)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:MOLESPHINI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FRANKLIN BLVD # B
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4530
Mailing Address - Country:US
Mailing Address - Phone:516-992-0205
Mailing Address - Fax:
Practice Address - Street 1:60 FRANKLIN BLVD # B
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4530
Practice Address - Country:US
Practice Address - Phone:516-992-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist