Healthcare Provider Details

I. General information

NPI: 1720615503
Provider Name (Legal Business Name): KATHERINE ELIZABETH MCGRATH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

IV. Provider business mailing address

: 47 NEW SCOTLAND AVENUE DEPT. OF PEDIATRICS
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-5461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24306
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: