Katie Kilgannon
Specialist in Staten Island, NY. Individual provider (NPI-1).
NPI number1982157954
StatusActive
Last updated in NPPESJul 26, 2016
Details
- NPI
- 1982157954
- Entity type
- Individual (NPI-1)
- Name
- Katie Kilgannon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 26, 2016
- Last updated
- Jul 26, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
121 McBaine AveStaten Island, NY 10309-1610
Phone 718-948-6366
Mailing address
121 McBaine AveStaten Island, NY 10309-1610
Phone 718-948-6366
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