Individual
KELLY ROSE BIRCHENOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
830 WASHINGTON ST, WATERTOWN, NY 13601-4099
(315) 786-4900
Mailing address
830 WASHINGTON ST, WATERTOWN, NY 13601-4099
(315) 786-4900
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
298638
NY
207V00000X
Obstetrics & Gynecology Physician
OS017606
PA
Other
Enumeration date
04/21/2011
Last updated
10/10/2025
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