1023165586 NPI number — CATHERINE ADISSI NP

Table of content: CATHERINE ADISSI NP (NPI 1023165586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023165586 NPI number — CATHERINE ADISSI NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADISSI
Provider First Name:
CATHERINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023165586
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 WESTCHESTER PARK DR STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10604-3497
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-948-8003
Provider Business Mailing Address Fax Number:
914-686-5478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 WESTCHESTER PARK DR FL 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10604-3434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-948-8448
Provider Business Practice Location Address Fax Number:
914-948-0351
Provider Enumeration Date:
01/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  F333986-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)