Provider Demographics
NPI:1275543944
Name:DOWNEY, KATHLEEN B (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:B
Last Name:DOWNEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1783 ROUTE 9
Practice Address - Street 2:SUITE 102
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2409
Practice Address - Country:US
Practice Address - Phone:518-383-8191
Practice Address - Fax:518-383-9232
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NY158835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01545293Medicaid
NY01545293Medicaid
NYBD2508642OtherDEA
E62546Medicare UPIN