Healthcare Provider Details

I. General information

NPI: 1689674095
Provider Name (Legal Business Name): CATHERINE ROBERTS BARTHOLOMEW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5276
  • Fax: 518-262-6470
Mailing address:
  • Phone: 518-262-5276
  • Fax: 518-262-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number165049
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number83389
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01090499A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: