Individual
KAITLYN E BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
560 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-0250
Mailing address
111 GALWAY PL, TEANECK, NJ 07666-3640
(201) 833-9500
(201) 862-0095
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00245300
NJ
Other
Enumeration date
12/29/2010
Last updated
08/09/2022
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