Healthcare Provider Details

I. General information

NPI: 1457585853
Provider Name (Legal Business Name): CATHERINE ANN ORIGLIERI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 GOLDEN VALLEY RD STE 100
GOLDEN VALLEY MN
55427-4472
US

IV. Provider business mailing address

8401 GOLDEN VALLEY RD STE 330
GOLDEN VALLEY MN
55427-4687
US

V. Phone/Fax

Practice location:
  • Phone: 763-416-7600
  • Fax:
Mailing address:
  • Phone: 763-416-7600
  • Fax: 763-416-7634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA10238600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number72651
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: