Healthcare Provider Details

I. General information

NPI: 1326545245
Provider Name (Legal Business Name): KATHRYN ALLISON SAXBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 MEETING HOUSE LANE SUITE 403 BLDG 2
SOUTHAMPTON NY
11968
US

IV. Provider business mailing address

325 MEETING HOUSE LN STE 403 BUILDING 2
SOUTHAMPTON NY
11968-7000
US

V. Phone/Fax

Practice location:
  • Phone: 631-283-2100
  • Fax: 631-283-5731
Mailing address:
  • Phone: 631-283-2100
  • Fax: 631-283-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number317550
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: