Healthcare Provider Details

I. General information

NPI: 1275846032
Provider Name (Legal Business Name): KATHARINE ANNE DILLEHAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHARINE ANNE BRADFORD

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 WINDSOR HWY
NEWBURGH NY
12553-6200
US

IV. Provider business mailing address

67 WINDSOR HWY
NEWBURGH NY
12553-6200
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-0022
  • Fax: 845-692-7111
Mailing address:
  • Phone: 845-692-0022
  • Fax: 845-692-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: