Individual
KATHLEEN PORMENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
92 2ND ST, HACKENSACK, NJ 07601-2191
(551) 996-5855
Mailing address
130 SUTTER ST FL 2, SAN FRANCISCO, CA 94104-4009
(415) 658-6791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00372200
NJ
363A00000X
Physician Assistant
—
NY
Other
Enumeration date
08/25/2015
Last updated
04/03/2020
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