1376361253 NPI number — MRS. CATHERINE FORTIN ROY MD

Table of content: MRS. CATHERINE FORTIN ROY MD (NPI 1376361253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376361253 NPI number — MRS. CATHERINE FORTIN ROY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROY
Provider First Name:
CATHERINE
Provider Middle Name:
FORTIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1376361253
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 CHEMIN DE LA VALLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHELSEA
Provider Business Mailing Address State Name:
QUEBEC
Provider Business Mailing Address Postal Code:
J9B 1M3
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3745 CHEMIN DE LA COTE-SAINTE-CATHERINE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTREAL
Provider Business Practice Location Address State Name:
QUEBEC
Provider Business Practice Location Address Postal Code:
H3T 1E2
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
514-340-8222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2024

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: 207Y00000X , with the licence number:  R27861 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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