Healthcare Provider Details

I. General information

NPI: 1891754487
Provider Name (Legal Business Name): CATHERINE K MAYOTT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE KREYER NP

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PATROON CREEK BLVD SUITE 210
ALBANY NY
12206-5013
US

IV. Provider business mailing address

63 SHAKER RD SUITE 102
ALBANY NY
12204-1030
US

V. Phone/Fax

Practice location:
  • Phone: 518-459-8106
  • Fax: 518-489-6441
Mailing address:
  • Phone: 518-207-2710
  • Fax: 518-207-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number302332
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: