Healthcare Provider Details

I. General information

NPI: 1619196292
Provider Name (Legal Business Name): CATHERINE MARY CORRIGAN ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 SENECA AVE
RIDGEWOOD NY
11385-1340
US

IV. Provider business mailing address

65 HIGH ST
EAST WILLISTON NY
11596-1923
US

V. Phone/Fax

Practice location:
  • Phone: 718-483-7416
  • Fax: 718-366-2936
Mailing address:
  • Phone: 516-414-2943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF303284-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: