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NPI Code Detail

MEDICARE: KATHLEEN DUCKETT PA

MEDICARE: KATHLEEN DUCKETT PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant034876-01NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1790549301
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN DUCKETT PA
Provider Business Mailing Address
First Line : 7492 NORTHGATE DR
Second Line :
City : HANAHAN
State : SC
Zip : 29410-8202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 211 CHURCH ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-1090
Country : US
Telephone Number : 518-587-3222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2024
Last Update Date : 01/09/2026

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Directions to “ KATHLEEN DUCKETT PA” Practice Location

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