Healthcare Provider Details

I. General information

NPI: 1407273550
Provider Name (Legal Business Name): KATHERINE ANNE LEGARE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 WAINSCOTT NW ROAD
WAINSCOTT NY
11937-8101
US

IV. Provider business mailing address

83 WAINSCOTT NW ROAD
WAINSCOTT NY
11937-8101
US

V. Phone/Fax

Practice location:
  • Phone: 631-632-2428
  • Fax:
Mailing address:
  • Phone: 631-632-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number281420
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number281420
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number281420
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: