Provider Demographics
NPI:1902891534
Name:KATCHEN, H JEFFREY (PA-C)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:JEFFREY
Last Name:KATCHEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:HOWARD
Other - Middle Name:JEFFREY
Other - Last Name:KATCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:289 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VT
Mailing Address - Zip Code:05089-9000
Mailing Address - Country:US
Mailing Address - Phone:802-674-7220
Mailing Address - Fax:802-674-7006
Practice Address - Street 1:289 COUNTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-9000
Practice Address - Country:US
Practice Address - Phone:802-674-7220
Practice Address - Fax:802-674-7006
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT055-0030283363AM0700X
NH0266363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT2001000Medicaid
NH30010566Medicaid
VT9000370Medicaid
VT9000370Medicaid
VT2001000Medicaid
NH001470201Medicare PIN