Provider Demographics
NPI:1699061077
Name:POWERS, KATE ELIZABETH (DO)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:ELIZABETH
Last Name:POWERS
Suffix:
Gender:F
Credentials:DO
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:AMC PEDIATRIC PULMONARY GROUP
Mailing Address - Street 2:22 NEW SCOTLAND AVE-MC 88
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-262-6880
Mailing Address - Fax:518-262-6884
Practice Address - Street 1:22 NEW SCOTLAND AVENUE, 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-262-6880
Practice Address - Fax:518-262-6884
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIDO00877208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04891567Medicaid