MEDICARE: MRS. CATHERINE LIM SIAZON-LEVISTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	180603	NY

General Provider Information

NPI Number	:	1861593873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE LIM SIAZON-LEVISTE MD

Provider Business Mailing Address
First Line	:	29 DAHLGREN PLACE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228
Country	:	US
Telephone Number	:	718-921-4393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 SILVER STREET
Second Line	:	CONNECTICUT VALLEY HOSPITAL
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-7023
Country	:	US
Telephone Number	:	860-262-5868
Fax Number	:	860-262-5850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	09/18/2007

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