MEDICARE: CATHERINE JAMES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36-3487171	OTHER	NY	FEIN NUMBER

General Provider Information

NPI Number	:	1629493432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE JAMES

Provider Business Mailing Address
First Line	:	441 W KIRKPATRICK ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13204-1305
Country	:	US
Telephone Number	:	315-472-4201
Fax Number	:	315-472-4202

Provider Business Practice Location Address
First Line	:	441 W KIRKPATRICK ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13204-1305
Country	:	US
Telephone Number	:	315-472-4201
Fax Number	:	315-472-4202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2014
Last Update Date	:	03/03/2014

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Directions to “ CATHERINE JAMES ” Practice Location

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