Healthcare Provider Details

I. General information

NPI: 1699796292
Provider Name (Legal Business Name): CATHERINE L MARSH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S MANNING BLVD
ALBANY NY
12208-1742
US

IV. Provider business mailing address

319 S MANNING BLVD
ALBANY NY
12208-1742
US

V. Phone/Fax

Practice location:
  • Phone: 518-438-0981
  • Fax:
Mailing address:
  • Phone: 518-438-0981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberF303351-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: