Provider Demographics
NPI:1447340229
Name:GITLIN, KEVIN N (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:N
Last Name:GITLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1850
Mailing Address - Country:US
Mailing Address - Phone:518-566-6000
Mailing Address - Fax:518-561-0674
Practice Address - Street 1:3 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1850
Practice Address - Country:US
Practice Address - Phone:518-566-6000
Practice Address - Fax:518-561-0674
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1770372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF28587Medicare UPIN
NYAA0709Medicare PIN