Doctor Name: | KELSEY H. TATONE |
NPI Number: | 1417290388 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C |
License Number: | C0005030 |
Business Practice Address: | 77 W Barney St Gouverneur, NY - 136421040 |
Business Phone Number: | 3152874440 |
Business Fax Number: | 3152871858 |
Mailing Address: | 4 Commerce Ln, CANTON |
State: | NY |
Postal Code: | 136173739 |
Phone Number: | 3153868191 |
Fax Number: | 3153861410 |
NPI Enumeration Date: | 03/29/2013 |
NPI Last Update Date: | 07/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | C0005030 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |