1639273881 NPI number — MRS. CATHERINE ELIZABETH FINK RD CDN

Table of content: MRS. CATHERINE ELIZABETH FINK RD CDN (NPI 1639273881)

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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