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General NPI Number Information
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NPI Number | 1063171007
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Entity Type | Organization
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Legal Business Name | CATHY HEALTHCARE LLC
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 2 W ROLLING XRDS STE 111
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City | CATONSVILLE
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State | MD
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Zip | 21228-6211
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Country | US
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Telephone | 410-581-0362
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CYPRESS GROVE CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-6703
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Country | US
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Telephone | 443-768-7995
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. OSEREMEN LAURETTA OKOJIE
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Credential | CRNP
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Telephone | 443-768-7995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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