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General NPI Number Information
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NPI Number | 1184157240
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Entity Type | Individual
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Provider Name | KATIE LOU KING MD
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Gender | Female
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1561 LONG POND RD STE 130
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City | ROCHESTER
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State | NY
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Zip | 14626-4136
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Country | US
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Telephone | 585-723-7765
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Fax | 585-723-3637
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Provider Business Mailing Address
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Address Line | 100 KINGS HWY S
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City | ROCHESTER
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State | NY
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Zip | 14617-5504
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Country | US
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Telephone | 585-922-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 315821
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License Number State | NY
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