Provider Demographics
NPI:1730268350
Name:MESSINA, KATHY MICHELE (MD)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:MICHELE
Last Name:MESSINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 BARBARA LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4704
Mailing Address - Country:US
Mailing Address - Phone:516-222-0228
Mailing Address - Fax:516-745-1519
Practice Address - Street 1:BLDG 19 WEST ROAD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-222-0228
Practice Address - Fax:516-745-1519
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204784208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics