Individual
KATELYN ALYSSA DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
45 RESEARCH WAY STE 108, EAST SETAUKET, NY 11733-6401
(631) 941-2000
(631) 941-2010
Mailing address
5 EVA LN, FARMINGVILLE, NY 11738-1010
(631) 624-7943
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F309820-01
NY
Other
Enumeration date
10/27/2020
Last updated
11/02/2021
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