Individual
KATHLEEN MATTOON VANDERBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4 COULTER RD STE 1680, CLIFTON SPRINGS, NY 14432-1122
(315) 906-4059
(315) 906-4132
Mailing address
601 ELMWOOD AVE, BOX 652, ROCHESTER, NY 14642-0001
(585) 275-7741
(585) 244-4320
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01545275
—
NY
Enumeration date
08/05/2006
Last updated
05/19/2021
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