Individual
KATHLEEN MAURO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT ACE
Contact information
Practice address
2500 NESCONSET HWY BLDG 26, STONY BROOK, NY 11790-2555
(631) 364-9038
Mailing address
2500 NESCONSET HWY BLDG 26, STONY BROOK, NY 11790-2555
(631) 364-9038
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
133NN1002X
Nutrition Education Nutritionist
—
NY
3747P1801X
Personal Care Attendant
Primary
T27075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T27075
AMERICAN COUNCIL ON EXERCISE- PERSONAL TRAINER CERTIFICATE
NY
Enumeration date
05/30/2025
Last updated
05/30/2025
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