Healthcare Provider Details

I. General information

NPI: 1770802357
Provider Name (Legal Business Name): CATHERINE MICHELS ALONZO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE LEA MICHELS M.D.

II. Dates (important events)

Enumeration Date: 05/22/2010
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 LAKE AVE SUITE 201
GREENWICH CT
06830-4501
US

IV. Provider business mailing address

16 FOX RIDGE RD
ARMONK NY
10504-2219
US

V. Phone/Fax

Practice location:
  • Phone: 203-869-1285
  • Fax: 203-737-8035
Mailing address:
  • Phone: 718-570-5063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number241260
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number49084
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: