Provider Demographics
NPI:1295802528
Name:GAJDOS, KATHLEEN CURZIE
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:CURZIE
Last Name:GAJDOS
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 27
Mailing Address - Street 2:
Mailing Address - City:QUECHEE
Mailing Address - State:VT
Mailing Address - Zip Code:05059-0027
Mailing Address - Country:US
Mailing Address - Phone:610-388-2888
Mailing Address - Fax:484-259-7224
Practice Address - Street 1:206 HIRAM ATKINS BYWAY
Practice Address - Street 2:
Practice Address - City:QUECHEE
Practice Address - State:VT
Practice Address - Zip Code:05059-3126
Practice Address - Country:US
Practice Address - Phone:610-388-2888
Practice Address - Fax:484-259-7224
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000661103T00000X
VT048.0134757103T00000X
MAPSY10553103T00000X
PAPS002961L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA081103Medicare UPIN
PA081103Medicare ID - Type UnspecifiedMEDICARE