Provider Demographics
NPI:1205819240
Name:WEBSTER, KATHRYN G (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:G
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 INTREPID LN
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-2552
Mailing Address - Country:US
Mailing Address - Phone:315-469-8191
Mailing Address - Fax:315-469-4482
Practice Address - Street 1:151 INTREPID LN
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-2552
Practice Address - Country:US
Practice Address - Phone:315-469-8191
Practice Address - Fax:315-469-4482
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics