Provider Demographics
NPI:1588293666
Name:AUSTIN, KATHLEEN (DO)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:ODONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7995 CALL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-4114
Mailing Address - Country:US
Mailing Address - Phone:585-345-1779
Mailing Address - Fax:585-345-1862
Practice Address - Street 1:7995 CALL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-4114
Practice Address - Country:US
Practice Address - Phone:585-345-1779
Practice Address - Fax:585-345-1862
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324063-01207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine