Fanos, Kathleen H

Fanos, Kathleen H is an individual health care provider with primary practice located at 15 S Main St Suite 150, Jamestown NY 14701-6626. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Fanos, Kathleen H can be contacted via phone (716) 484-3776.

Contact Information

Primary practice address
15 S Main St Suite 150 Jamestown NY 14701-6626
Phone: (716) 484-3776
Fax: (716) 484-3777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 18127 Mississippi
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200860 New York

Profile Details

NPI number 1427068782
LBN Legal business name Fanos, Kathleen H
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Feb 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427068782 NPPES
New York Other J400168920 MEDICARE PTAN
New York MEDICAID 2275670 MEDICARE PTAN

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