Provider Demographics
NPI:1063756633
Name:VASEY, KATHERINE MARIA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIA
Last Name:VASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 FRENCH RD.
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-3632
Mailing Address - Country:US
Mailing Address - Phone:716-207-1845
Mailing Address - Fax:
Practice Address - Street 1:928 FRENCH RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-3632
Practice Address - Country:US
Practice Address - Phone:716-207-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor