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
Fax: (585) 922-0470
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306814660 NPPES
New York MEDICAID 00762047

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