Provider Demographics
NPI:1073171427
Name:MOYLE, CATHERINE (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:MOYLE
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:DIFRISCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:40 HEDGES AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2547
Mailing Address - Country:US
Mailing Address - Phone:517-967-5430
Mailing Address - Fax:
Practice Address - Street 1:424 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4901
Practice Address - Country:US
Practice Address - Phone:212-263-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY688160363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY688160OtherREGISTERED NURSE LICENSE