Provider Demographics
NPI:1689663098
Name:STARKEY, KATHRYN TERESA (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TERESA
Last Name:STARKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N SEWARD AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2107
Mailing Address - Country:US
Mailing Address - Phone:315-253-9749
Mailing Address - Fax:315-253-2614
Practice Address - Street 1:615 N SEWARD AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-2107
Practice Address - Country:US
Practice Address - Phone:315-253-9749
Practice Address - Fax:315-252-3911
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1912501207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01398058Medicaid
E55002Medicare UPIN
50051FMedicare ID - Type Unspecified