1902573652 NPI number — MRS. HANNA CATHERINE PICHE PT, DPT

Table of content: MRS. HANNA CATHERINE PICHE PT, DPT (NPI 1902573652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902573652 NPI number — MRS. HANNA CATHERINE PICHE PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PICHE
Provider First Name:
HANNA
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CORLISS
Provider Other First Name:
HANNA
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902573652
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 CHALET CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTAMONT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-807-6912
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 SOUTH MANNING BOULEVARD
Provider Second Line Business Practice Location Address:
LANGAN SCHOOL
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-437-5680
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2021

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: 225100000X , with the licence number:  047925 , 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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