Healthcare Provider Details

I. General information

NPI: 1386896546
Provider Name (Legal Business Name): KATHARINE BILLS WOODS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 STEUBEN ST
MONTOUR FALLS NY
14865-9648
US

IV. Provider business mailing address

250 STEUBEN ST
MONTOUR FALLS NY
14865-9648
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-8626
  • Fax: 607-210-1983
Mailing address:
  • Phone: 607-535-8626
  • Fax: 607-210-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2640
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number029077
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: