Provider Demographics
NPI:1205689619
Name:FOX, KATHRYN (MD)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:
Last Name:FOX
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 1:101 NICOLLS RD.
Mailing Address - Street 2:HSC- LEVEL 11, RM 040
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:631-444-2020
Mailing Address - Fax:631-444-2894
Practice Address - Street 1:101 NICOLLS RD.
Practice Address - Street 2:HSC- LEVEL 11, RM 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-2020
Practice Address - Fax:631-444-2894
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program