Healthcare Provider Details

I. General information

NPI: 1598277659
Provider Name (Legal Business Name): KATHLEEN CELESTE RAGAN SET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 11/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5871 GROVELAND STATION RD
MOUNT MORRIS NY
14510-9767
US

IV. Provider business mailing address

5871 GROVELAND STATION RD
MOUNT MORRIS NY
14510-9767
US

V. Phone/Fax

Practice location:
  • Phone: 585-658-4023
  • Fax: 585-658-4066
Mailing address:
  • Phone: 585-658-4023
  • Fax: 585-658-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number186028871
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: