Vanderbrook, Kathleen Mattoon

Vanderbrook, Kathleen Mattoon is an individual health care provider with primary practice located at 4 Coulter Rd Ste 1680 , Clifton Springs NY 14432-1122. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Vanderbrook, Kathleen Mattoon can be contacted via phone (315) 906-4059.

Contact Information

Primary practice address
4 Coulter Rd Ste 1680 Clifton Springs NY 14432-1122
Phone: (315) 906-4059
Fax: (315) 906-4132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F300815 New York

Profile Details

NPI number 1255340782
LBN Legal business name Vanderbrook, Kathleen Mattoon
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated May 19th, 2021 - about 3 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 1255340782 NPPES
New York MEDICAID 01545275

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