Healthcare Provider Details

I. General information

NPI: 1609845858
Provider Name (Legal Business Name): CATHERINE LEGER-GODEK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 DEAN ST
TAUNTON MA
02780-2766
US

IV. Provider business mailing address

362 N BEDFORD ST
EAST BRIDGEWATER MA
02333-1148
US

V. Phone/Fax

Practice location:
  • Phone: 508-824-3872
  • Fax: 508-822-7975
Mailing address:
  • Phone: 508-350-2350
  • Fax: 508-350-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number205187
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: