Provider Demographics
NPI:1104248921
Name:NEGRILLO, CATHERINE (ACNP-BC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:NEGRILLO
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 MADISON AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2202
Mailing Address - Country:US
Mailing Address - Phone:212-996-3622
Mailing Address - Fax:
Practice Address - Street 1:2160 MADISON AVE
Practice Address - Street 2:APT 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2202
Practice Address - Country:US
Practice Address - Phone:212-996-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430771363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care