Healthcare Provider Details

I. General information

NPI: 1992003768
Provider Name (Legal Business Name): PUTNAM WESTCHESTER SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 STONELEIGH AVE SUITE C-116
CARMEL NY
10512-4634
US

IV. Provider business mailing address

672 STONELEIGH AVE SUITE C-116
CARMEL NY
10512-4634
US

V. Phone/Fax

Practice location:
  • Phone: 845-582-0919
  • Fax: 845-582-0922
Mailing address:
  • Phone: 845-582-0911
  • Fax: 845-582-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number228725
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number137996
License Number StateNY

VIII. Authorized Official

Name: DR. PAUL MCDONNELL CATHCART
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-582-0911