1639273881 NPI number — MRS. CATHERINE ELIZABETH FINK RD CDN

Table of content: EMILY H HARTNETT FNP-C (NPI 1891441911)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639273881 NPI number — MRS. CATHERINE ELIZABETH FINK RD CDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINK
Provider First Name:
CATHERINE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD CDN
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:
1639273881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39 MULBERRY STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PALTZ
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12561
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-810-0448
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
243 MAIN STREET
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
NEW PALTZ
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-255-1978
Provider Business Practice Location Address Fax Number:
845-625-1452
Provider Enumeration Date:
09/09/2006

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: 133V00000X , with the licence number:  0049161 , 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)

  • Identifier: 210012 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2549170 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10044884 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 25212 . This is a "HUDSON HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 47583 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 351719 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7374210 . This is a "AETNA PPO POS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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