Provider Demographics
NPI:1730469719
Name:URBAN, KATHLEEN MELISSA (MA)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MELISSA
Last Name:URBAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:40 JON BARRETT RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2164
Mailing Address - Country:US
Mailing Address - Phone:845-878-9078
Mailing Address - Fax:845-278-6984
Practice Address - Street 1:15 MOUNT EBO RD S
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4004
Practice Address - Country:US
Practice Address - Phone:845-878-9078
Practice Address - Fax:845-278-6984
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006444225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics