Katlic, Kerry L
Katlic, Kerry L is an individual health care provider with primary practice located at 2067 Fairport Nine Mile Pt Rd , Penfield NY 14526-1753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Katlic, Kerry L can be contacted via phone (585) 922-0460.Contact Information
Primary practice address
2067 Fairport Nine Mile Pt Rd
Penfield NY 14526-1753
Phone: (585) 922-0460
Fax: (585) 922-0470
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 146679 | New York |
Profile Details
| NPI number | 1306814660 |
|---|---|
| LBN Legal business name | Katlic, Kerry L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2006 |
| Last updated | May 12th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306814660 | NPPES |
| New York | MEDICAID | 00762047 |
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