Provider Demographics
NPI:1295096212
Name:BOLENDER, KATHARINE S
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:S
Last Name:BOLENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:NORTH SALEM
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-0421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 JUNE RD
Practice Address - Street 2:NORTH SALEM
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-1702
Practice Address - Country:US
Practice Address - Phone:914-774-3608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist