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General NPI Number Information
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NPI Number | 1740472869
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Entity Type | Individual
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Provider Name | DR. CATHERINE CAGIANNOS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 97 CASTLEGROVE BLVD
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City | LONDON
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State | ONTARIO
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Zip | N6G3T3
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Country | CA
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Telephone | 15196574783
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Fax |
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Provider Business Mailing Address
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Address Line | 97 CASTLEGROVE BLVD
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City | LONDON
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State | ONTARIO
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Zip | N6G3T3
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Country | CA
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Telephone | 15196574783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 35.083528C
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34950
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 34950
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 34950
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35.083528C
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License Number State | OH
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