Provider Demographics
NPI:1366836330
Name:DOHERTY, KATIRIA (MS)
Entity Type:Individual
Prefix:MRS
First Name:KATIRIA
Middle Name:
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WINDSOR TER
Mailing Address - Street 2:APT 3D
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3736
Mailing Address - Country:US
Mailing Address - Phone:914-689-1214
Mailing Address - Fax:
Practice Address - Street 1:2700 WESTCHESTER AVE
Practice Address - Street 2:#300
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2547
Practice Address - Country:US
Practice Address - Phone:914-328-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist