Provider Demographics
NPI:1902321433
Name:PEARL, CATHERINE LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LYNNE
Last Name:PEARL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 JADE WAY
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-7814
Mailing Address - Country:US
Mailing Address - Phone:516-532-1758
Mailing Address - Fax:
Practice Address - Street 1:333 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3758
Practice Address - Country:US
Practice Address - Phone:212-308-2540
Practice Address - Fax:212-308-2555
Is Sole Proprietor?:No
Enumeration Date:2017-08-05
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324410-1163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic