Individual
DR. KATHRYN ANN BAMFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
620 CROSS KEYS OFFICE PARK, FAIRPORT, NY 14450-3508
(585) 223-5920
(585) 223-5727
Mailing address
68 LASALLE PARKWAY, VICTOR, NY 14564
(585) 704-0859
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0114501
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01405590
—
NY
01
—
5434313
AETNA
NY
01
—
P010011450
BLUE CHOICE
NY
01
—
P030011450
BLUE CROSS BLUE SHIELD
NY
Enumeration date
09/28/2006
Last updated
04/23/2012
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