Healthcare Provider Details

I. General information

NPI: 1699061077
Provider Name (Legal Business Name): KATE ELIZABETH POWERS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 NEW SCOTLAND AVENUE, 3RD FLOOR
ALBANY NY
12208
US

IV. Provider business mailing address

AMC PEDIATRIC PULMONARY GROUP 22 NEW SCOTLAND AVE-MC 88
ALBANY NY
12208
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-6880
  • Fax: 518-262-6884
Mailing address:
  • Phone: 518-262-6880
  • Fax: 518-262-6884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO00877
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: