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General NPI Number Information
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NPI Number | 1770108474
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Entity Type | Individual
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Provider Name | KAITLIN WILCOVE RPA-C
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Gender | Female
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 6 HENRY ST
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City | BEACON
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State | NY
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Zip | 12508-3058
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Country | US
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Telephone | 845-831-0400
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Fax | 845-765-9400
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Provider Business Mailing Address
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Address Line | PO BOX 5036
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City | WHITE PLAINS
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State | NY
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Zip | 10602-5036
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Country | US
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Telephone | 845-745-3611
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 025390
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License Number State | NY
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