Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathryn Kohananoo, AGPCNP

Individual provider Adult Health Nurse Practitioner · NPI 1306563762

Kathryn Kohananoo, AGPCNP is a Nurse Practitioner in Roslyn, New York. Qualified in 2022, 4 years ago. Practices with Southwest Suffolk Medical PC, a 200-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

100 Port Washington Blvd
Roslyn, NY 11576-1353
Phone: (516) 562-6373
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F310990 (NY)

Record details

NPI number1306563762
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP
Sole proprietorNo
NPI enumeratedOctober 25, 2022
Last updated in NPPESOctober 25, 2022
Certification dateOctober 25, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southwest Suffolk Medical Pc — 200 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Roslyn