Provider Demographics
NPI:1861255044
Name:MEDCRAFT, CATHERINE L
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:MEDCRAFT
Suffix:
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:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-0060
Mailing Address - Country:US
Mailing Address - Phone:973-222-2193
Mailing Address - Fax:
Practice Address - Street 1:235 LACKAWANNA DR
Practice Address - Street 2:
Practice Address - City:BYRAM TWP
Practice Address - State:NJ
Practice Address - Zip Code:07821-4111
Practice Address - Country:US
Practice Address - Phone:862-432-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care