Basic Information
Provider Information
NPI: 1063672905
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOX
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 416457
Address2:  
City: BOSTON
State: MA
PostalCode: 022416457
CountryCode: US
TelephoneNumber: 8443621735
FaxNumber: 9732907495
Practice Location
Address1: 100 MADISON AVE
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739715449
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2008
LastUpdateDate: 09/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0002X25MA09482200NJY Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

No ID Information.


Home