Healthcare Provider Details

I. General information

NPI: 1306340344
Provider Name (Legal Business Name): KATHLEEN M. MCLOUGHLIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN M. BARZELATTO

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5437
  • Fax:
Mailing address:
  • Phone: 610-334-8341
  • Fax: 610-649-4735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018704
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP018704
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382913
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN595928
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberSP018704
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number667890
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number382913
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: