Individual
MRS. KATHLEEN MARY NEWFROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1040 CONKLIN RD, CONKLIN, NY 13748-1136
(607) 775-9108
Mailing address
3000 COLUMBIA DR, ENDWELL, NY 13760-2306
(607) 754-4441
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
512565-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01505531
—
NY
Enumeration date
05/21/2012
Last updated
05/21/2012
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