Provider Demographics
NPI:1316016868
Name:WARD, KATHLEEN E (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3755 HENRY HUDSON PKWY
Mailing Address - Street 2:#14G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1535
Mailing Address - Country:US
Mailing Address - Phone:718-884-2390
Mailing Address - Fax:
Practice Address - Street 1:JACOBI MEDICAL CENTER
Practice Address - Street 2:1400 PELHAM PARKWAY SOUTH
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5755
Practice Address - Fax:718-918-7701
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
NY142653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C08382Medicare UPIN