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General NPI Number Information
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NPI Number | 1689646549
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Entity Type | Individual
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Provider Name | KATHLEEN M GARBOOSHIAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 1729 BURRSTONE RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-1001
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Country | US
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Telephone | 315-798-1702
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Fax | 315-798-1726
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Provider Business Mailing Address
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Address Line | 1801 BLACK RIVER BLVD N
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City | ROME
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State | NY
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Zip | 13440-2427
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Country | US
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Telephone | 315-337-3770
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 217024
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License Number State | NY
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