Healthcare Provider Details

I. General information

NPI: 1700818333
Provider Name (Legal Business Name): CATHERINE A. DUBOIS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 SHUFELT RD
CHATHAM NY
12037-3514
US

IV. Provider business mailing address

43 SHUFELT RD
CHATHAM NY
12037-3514
US

V. Phone/Fax

Practice location:
  • Phone: 518-755-3171
  • Fax:
Mailing address:
  • Phone: 518-755-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5296
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: