Provider Demographics
NPI:1528407558
Name:WALTER, KATHRYN G
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:G
Last Name:WALTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROLLING HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-1926
Mailing Address - Country:US
Mailing Address - Phone:518-461-0074
Mailing Address - Fax:
Practice Address - Street 1:14 ROLLING HILLS RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-1926
Practice Address - Country:US
Practice Address - Phone:518-456-8469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist