1376783415 NPI number — MRS. SANDRA MARIE CATLIN MSED, CCC/L-SLP

Table of content: MS. JANICE LYNN RAKOFF LCSW (NPI 1083992176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376783415 NPI number — MRS. SANDRA MARIE CATLIN MSED, CCC/L-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CATLIN
Provider First Name:
SANDRA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSED, CCC/L-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRANGER
Provider Other First Name:
SANDRA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSED, CCC/L-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376783415
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
762 56 ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PETERSBURG
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-378-7812
Provider Business Mailing Address Fax Number:
518-286-2331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
762 56 ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PETERSBURG
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-378-7812
Provider Business Practice Location Address Fax Number:
518-286-2331
Provider Enumeration Date:
03/03/2009

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: 235Z00000X , with the licence number:  009773-1 , 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)





Copyright © 2007-2024 www.npivalidator.com