Provider Demographics
NPI:1992063382
Name:MA, KATHERINE CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CRAIG
Last Name:MA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 SOUTH BEDFORD ROAD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:
Practice Address - Street 1:1978 CROMPOND ROAD
Practice Address - Street 2:CAREMOUNT MEDICAL PC
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4115
Practice Address - Country:US
Practice Address - Phone:914-739-6096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269535207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03641958Medicaid
NYA400094041Medicare PIN