MEDICARE: KATHRYN FLETCHER M.D.

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
1	2080N0001X	Neonatal-Perinatal Medicine Physician	036145995	IL
2	2080N0001X	Neonatal-Perinatal Medicine Physician	A137437	CA
3	2080N0001X	Neonatal-Perinatal Medicine Physician	68691	CT

General Provider Information

NPI Number	:	1952661936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN FLETCHER M.D.

Provider Business Mailing Address
First Line	:	430 CONGRESS AVE FL 1
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1313
Country	:	US
Telephone Number	:	203-688-2320
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 CONGRESS AVE FL 1
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1313
Country	:	US
Telephone Number	:	203-688-2320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	08/12/2021

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