Provider Demographics
NPI:1861089740
Name:BRUNOT, CATHIA (CEO)
Entity type:Individual
Prefix:
First Name:CATHIA
Middle Name:
Last Name:BRUNOT
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:CATHIA
Other - Middle Name:B
Other - Last Name:DOXY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CEO
Mailing Address - Street 1:1605 WIDENER PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1815
Mailing Address - Country:US
Mailing Address - Phone:267-225-0703
Mailing Address - Fax:
Practice Address - Street 1:1605 WIDENER PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1815
Practice Address - Country:US
Practice Address - Phone:267-225-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner