Provider Demographics
NPI:1598233413
Name:STITT, KATELYN MACDONALD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MACDONALD
Last Name:STITT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MINIER
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1000 ELMWOOD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3093
Mailing Address - Country:US
Mailing Address - Phone:585-271-0761
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3093
Practice Address - Country:US
Practice Address - Phone:585-271-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist