Provider Demographics
NPI:1558527655
Name:MALHAME, KATHRYN (NURSE PRACTITIONER/A)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MALHAME
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER/A
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:O'DONOGHUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:177 FORT WASHINGTON AVE
Mailing Address - Street 2:NY COLUMBIA PRESBYTERIAN HOSPITAL MILSTEIN BLDG 5GS-435
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3733
Mailing Address - Country:US
Mailing Address - Phone:516-680-2902
Mailing Address - Fax:
Practice Address - Street 1:177 FORT WASHINGTON AVE
Practice Address - Street 2:NY COLUMBIA PRESBYTERIAN HOSPITAL MILSTEIN BLDG 5GS-435
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3733
Practice Address - Country:US
Practice Address - Phone:516-680-2902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304826-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health