Healthcare Provider Details

I. General information

NPI: 1205178969
Provider Name (Legal Business Name): KATHERINE ROWAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 MONTAUK HWY STE 1B
WEST ISLIP NY
11795-4400
US

IV. Provider business mailing address

71 WASHINGTON ST
BABYLON NY
11702-1817
US

V. Phone/Fax

Practice location:
  • Phone: 631-306-4607
  • Fax: 631-532-4924
Mailing address:
  • Phone: 860-985-1279
  • Fax: 833-455-9192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number278179
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: