Individual
KATHLEEN M MYLOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7264 NASH RD, NORTH TONAWANDA, NY 14120-1508
(716) 694-7700
Mailing address
2875 UNION RD, SUITE 8, CHEEKTOWAGA, NY 14227-1465
(716) 651-0911
(716) 651-9855
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
125943
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010124505
UNIVERA
NY
01
—
000508674005
BC/BS
NY
05
—
01043461
—
NY
01
—
040511000519
FIDELIS
NY
01
—
151122BJ
PREFERRED CARE
NY
01
—
2208900
IHA
NY
Enumeration date
10/03/2005
Last updated
11/24/2009
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