Provider Demographics
NPI:1376608364
Name:GOLAR, KATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:GOLAR
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 1:982 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-1913
Mailing Address - Country:US
Mailing Address - Phone:203-696-3260
Mailing Address - Fax:203-683-3620
Practice Address - Street 1:471 BARNUM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-2409
Practice Address - Country:US
Practice Address - Phone:203-333-3030
Practice Address - Fax:203-683-3620
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004915207Q00000X, 207R00000X
NY188348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine