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General NPI Number Information
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NPI Number | 1912223595
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Entity Type | Organization
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Legal Business Name | KATHLEEN A BOWEN NP OF PSYCHIATRY PC.
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 28 N COUNTRY RD
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1347
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Country | US
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Telephone | 631-689-5390
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Fax | 631-689-5395
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Provider Business Mailing Address
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Address Line | 28 N COUNTRY RD
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1347
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Country | US
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Telephone | 631-689-5390
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Fax | 631-689-5395
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Authorized Official
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Title or Position | OWNER/NURSEPRACTITIONER
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Name | KATHLEEN A BOWEN
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Credential | N.P.
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Telephone | 631-689-5390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | F401202-1
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License Number State | NY
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