National Provider Identifier

Kerry L Katlic, M.D.

Kerry L Katlic, M.D. is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Penfield, NY and a listed phone number of (585) 922-0460.

NPI 1306814660Penfield, NYPediatrics Physician

Profile Overview

NPI
1306814660
Provider Type
Individual
Primary Specialty
Pediatrics Physician
Enumeration Date
March 10, 2006
Last Updated
May 12, 2011

Practice Location

  • 2067 Fairport Nine Mile PT RD
  • Penfield, NY 14526-1753

Phone: (585) 922-0460

Specialties

  • Pediatrics Physician (208000000X)
Full Record
NPI
1306814660
Entity Type
Individual
Last Name
Katlic
First Name
Kerry
Middle Name
L
Name Prefix
Dr.
Credential
M.D.
Mailing Street Address
2067 Fairport Nine Mile PT RD
Mailing City
Penfield
Mailing State
NY
Mailing ZIP Code
14526-1753
Mailing Country
US
Mailing Phone
(585) 922-0460
Mailing Fax
(585) 922-0470
Practice Street Address
2067 Fairport Nine Mile PT RD
Practice City
Penfield
Practice State
NY
Practice ZIP Code
14526-1753
Practice Country
US
Practice Phone
(585) 922-0460
Practice Fax
(585) 922-0470
Enumeration Date
March 10, 2006
Last Updated
May 12, 2011
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatrics Physician (208000000X)
Other Identifiers
00762047 (NY)