Healthcare Provider Details

I. General information

NPI: 1720204498
Provider Name (Legal Business Name): KATHARINE FRISCH BURNETT NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 TARRYTOWN RD
WHITE PLAINS NY
10607-1607
US

IV. Provider business mailing address

2363 FAIR AVE
COLUMBUS OH
43209-2158
US

V. Phone/Fax

Practice location:
  • Phone: 914-761-6566
  • Fax: 914-948-0010
Mailing address:
  • Phone: 914-912-3004
  • Fax: 413-637-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360269-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP-03826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: