Provider Demographics
NPI:1851380711
Name:HALTON, KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:HALTON
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 1:1176 5TH AVE.
Mailing Address - Street 2:MOUNT SINAI RADIOLOGY ASSOCIATES
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6503
Mailing Address - Country:US
Mailing Address - Phone:212-241-6381
Mailing Address - Fax:212-410-1973
Practice Address - Street 1:1176 5TH AVE.
Practice Address - Street 2:MOUNT SINAI RADIOLOGY ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-6381
Practice Address - Fax:212-410-1973
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1620252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01032122Medicaid
NY03E372Medicare PIN
NYA60046Medicare UPIN