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General NPI Number Information
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NPI Number | 1780087601
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Entity Type | Individual
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Provider Name | CATHERINE B PUANGCO FNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 12 N 7TH AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2026
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Country | US
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Telephone | 914-361-6277
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 750764
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City | FOREST HILLS
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State | NY
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Zip | 11375-0764
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F338672
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95001361
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License Number State | CA
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