Provider Demographics
NPI:1245575026
Name:MARSHALL, KATHERINE L (RPA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RPA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:STONY BROOK UNIVERSITY HOSPITAL DEPT. OF OB/GYN, HSC-T9
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8091
Mailing Address - Country:US
Mailing Address - Phone:631-444-4686
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:STONY BROOK UNIVERSITY HOSPITAL DEPT. OF OB/GYN, HSC-T9
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8091
Practice Address - Country:US
Practice Address - Phone:631-444-4686
Practice Address - Fax:631-444-4622
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2022-04-25
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Provider Licenses
StateLicense IDTaxonomies
NY016213363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant