Healthcare Provider Details

I. General information

NPI: 1952643587
Provider Name (Legal Business Name): KATE EWING KILBOURN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE EWING BEAUCHAMP M.D.

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 RED MILLS RD
WALLKILL NY
12589-3220
US

IV. Provider business mailing address

800 RED MILLS RD
WALLKILL NY
12589-3220
US

V. Phone/Fax

Practice location:
  • Phone: 845-744-9105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number268320
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number302374-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: