Provider Demographics
NPI:1518702505
Name:BREMER, KATERINA
Entity type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:BREMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATERINA
Other - Middle Name:
Other - Last Name:MODAFFERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KATERINA MODAFFERI
Mailing Address - Street 1:27 DENMAN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4305
Mailing Address - Country:US
Mailing Address - Phone:845-709-1268
Mailing Address - Fax:
Practice Address - Street 1:2 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1000
Practice Address - Country:US
Practice Address - Phone:845-651-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist