Organization
KATHLEEN VINE MD PC
Active
Organization
KATHLEEN VINE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN R VINE (MD)
(646) 421-6064
Entity
Organization
Contact information
Practice address
24 E 12TH ST # 304, NEW YORK, NY 10003-4513
(646) 421-6064
Mailing address
24 E 12TH ST # 304, NEW YORK, NY 10003-4513
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2628951
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2628951
STATE LISCENSE
NY
Enumeration date
05/27/2014
Last updated
05/27/2014
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