Provider Demographics
NPI:1548482839
Name:MUELLER, CATHERINE I
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MUELLER
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2303
Mailing Address - Country:US
Mailing Address - Phone:516-563-1131
Mailing Address - Fax:516-295-9245
Practice Address - Street 1:660 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2303
Practice Address - Country:US
Practice Address - Phone:516-563-1131
Practice Address - Fax:516-295-9245
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420448-1363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF420448-1OtherLICENSE #