Individual
DR. KATHLEEN T BRAICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
84 BROAD ST, GLENS FALLS, NY 12801-4381
(518) 798-9538
(518) 798-9576
Mailing address
84 BROAD ST, GLENS FALLS, NY 12801-4381
(518) 798-9538
(518) 798-9576
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
126814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00371040
—
NY
Enumeration date
07/10/2006
Last updated
07/08/2007
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