Look up the most recent NPI and PECOS records

Katherine Micetich

Specialist

Other Service Providers

329 E 149th St Fl 4, Bronx, NY 10451-5626

PECOS Enrollment

Based on the most recent information from CMS, provider Katherine Micetich does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 8:41 AM.

Profile Details

Provider ID
1003339508
Provider Type
Individual
Full Name
Micetich, Katherine
Title
Ms.
Credential
LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/18/2017
Last Updated
7/18/2017

Contact Information

Practice Location

329 E 149th St Fl 4, Bronx, NY 10451-5626

(718) 769-2698

Unlisted Fax

Mailing Location

3855 Orloff Ave Apt La, Bronx, NY 10463-2610

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 252Y00000X	Description Medicaid	Issuer Unlisted New York

Katherine Micetich

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hennessey, Karen Lynn

Murray, Serena

Sylvain, Geralda

Akindele, Oyetayo Mary

Anestat Pc

Reznik, Adel

E & A Medical Solutions Llc

Moreno, Esther

Le Guillan, Soazig

Grayson, Masani