Healthcare Provider Details

I. General information

NPI: 1447523451
Provider Name (Legal Business Name): CATHERINE MARGRET MCGOWAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CONKLIN ROAD SUSQUEHANNA VALLEY CENTRAL SCHOOL DISTRICT
CONKLIN NY
13748
US

IV. Provider business mailing address

128 FELTERS RD
BINGHAMTON NY
13903-2739
US

V. Phone/Fax

Practice location:
  • Phone: 607-775-0170
  • Fax:
Mailing address:
  • Phone: 607-722-1145
  • Fax: 607-722-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2083021
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: