Provider Demographics
NPI:1487984621
Name:ABBOTT, CATHERINE (RPA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WESTMINSTER RD
Mailing Address - Street 2:APT 3H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2853
Mailing Address - Country:US
Mailing Address - Phone:949-910-7276
Mailing Address - Fax:
Practice Address - Street 1:17 BRISTOL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5629
Practice Address - Country:US
Practice Address - Phone:718-495-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013482363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant