=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922714401
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHERINE POLICARPIO POLICINA MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2023
-----------------------------------------------------
Last Update Date | 07/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 406 W OAK ST
-----------------------------------------------------
City | TITUSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16354-1499
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-827-9770
-----------------------------------------------------
Fax | 817-827-3556
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2805 ALEXANDRA DR
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16506-5051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-794-5458
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | MD490660
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------