Provider Demographics
NPI:1912946740
Name:COLT, CATHY A (MD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:A
Last Name:COLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2045
Mailing Address - Country:US
Mailing Address - Phone:215-672-9030
Mailing Address - Fax:215-672-8099
Practice Address - Street 1:345 N YORK RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-2045
Practice Address - Country:US
Practice Address - Phone:215-672-9030
Practice Address - Fax:215-672-8099
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033904E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB98197Medicare UPIN
PA622437Medicare ID - Type Unspecified