Provider Demographics
NPI:1508954967
Name:BURNS, KATHARINE JEAN (RN MA CS)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:JEAN
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN MA CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WEST 86TH STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3616
Mailing Address - Country:US
Mailing Address - Phone:212-724-6991
Mailing Address - Fax:
Practice Address - Street 1:21 WEST 86TH STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3616
Practice Address - Country:US
Practice Address - Phone:212-724-6991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227400163W00000X
NY24385801364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S47080Medicare UPIN
NYRZ0681Medicare ID - Type Unspecified