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NPI Code Detail

MEDICARE: MS. KATHLEEN KRATOCHVIL LCSW

MEDICARE: MS. KATHLEEN KRATOCHVIL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker087420NY

General Provider Information

NPI Number : 1982953832
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN KRATOCHVIL LCSW
Provider Business Mailing Address
First Line : 55 DODGE RD
Second Line :
City : GETZVILLE
State : NY
Zip : 14068-1205
Country : US
Telephone Number : 716-831-2700
Fax Number :
Provider Business Practice Location Address
First Line : 77 BROADWAY ST
Second Line :
City : BUFFALO
State : NY
Zip : 14203-1642
Country : US
Telephone Number : 716-834-6401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 12/16/2024

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