Healthcare Provider Details

I. General information

NPI: 1699637207
Provider Name (Legal Business Name): KATELYN BURGO NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 COURT ST STE 260
BINGHAMTON NY
13901-3236
US

IV. Provider business mailing address

49 COURT ST STE 260
BINGHAMTON NY
13901-3236
US

V. Phone/Fax

Practice location:
  • Phone: 607-357-8668
  • Fax: 607-208-7593
Mailing address:
  • Phone:
  • Fax: 607-208-7593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATELYN BURGO
Title or Position: OWNER
Credential: NP
Phone: 607-208-7593