Provider Demographics
NPI:1811331325
Name:FIRE, KATE M (MS)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:M
Last Name:FIRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:M
Other - Last Name:BERNSTEIN-FIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:3128 BURRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-1735
Mailing Address - Country:US
Mailing Address - Phone:315-635-2849
Mailing Address - Fax:
Practice Address - Street 1:171 INTREPID LN
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-2548
Practice Address - Country:US
Practice Address - Phone:315-437-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist