1083998645 NPI number — DR. CATHERINE WHEELER CORBIN PH.D., LICENSED PSYC

Table of content: DR. CATHERINE WHEELER CORBIN PH.D., LICENSED PSYC (NPI 1083998645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083998645 NPI number — DR. CATHERINE WHEELER CORBIN PH.D., LICENSED PSYC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORBIN
Provider First Name:
CATHERINE
Provider Middle Name:
WHEELER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., LICENSED PSYC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHEELER
Provider Other First Name:
M. (ARY)
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D LICENSED.PSYCHO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1083998645
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
139 WASHINGTON AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLEASANTVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10570-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-769-5047
Provider Business Mailing Address Fax Number:
914-769-8059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 WASHINGTON AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLEASANTVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10570-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-769-5047
Provider Business Practice Location Address Fax Number:
914-769-8059
Provider Enumeration Date:
09/30/2011

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: 103TC0700X , with the licence number:  005497 , 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)





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