Provider Demographics
NPI:1811163330
Name:MAHAR, KATHERINE ELLEN (ANP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELLEN
Last Name:MAHAR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 ROUTE 212
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4619
Mailing Address - Country:US
Mailing Address - Phone:845-246-2804
Mailing Address - Fax:845-246-3053
Practice Address - Street 1:854 ROUTE 212
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-4619
Practice Address - Country:US
Practice Address - Phone:845-246-2804
Practice Address - Fax:845-246-3053
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304838-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health