Provider Demographics
NPI:1508429572
Name:HICKEY, KATHERINE ELIZABETH (DR,MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:HICKEY
Suffix:
Gender:F
Credentials:DR,MD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:SCHERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DR,MD
Mailing Address - Street 1:900 MONROE ST
Mailing Address - Street 2:APT 205
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030
Mailing Address - Country:US
Mailing Address - Phone:201-452-0711
Mailing Address - Fax:
Practice Address - Street 1:1184 5TH AVE MOUNT SINAI HOSPITAL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY315226208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program