Provider Demographics
NPI:1588205322
Name:DUFFY, KATE ELIZABETH
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:ELIZABETH
Last Name:DUFFY
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 1:56 BLOSSOM HEATH AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2006
Mailing Address - Country:US
Mailing Address - Phone:516-493-0190
Mailing Address - Fax:
Practice Address - Street 1:56 BLOSSOM HEATH AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2006
Practice Address - Country:US
Practice Address - Phone:516-493-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program