Provider Demographics
NPI:1861618399
Name:RELYEA, CATHY (NP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:RELYEA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WEBSTER AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1361
Mailing Address - Country:US
Mailing Address - Phone:845-483-5858
Mailing Address - Fax:845-483-5776
Practice Address - Street 1:1 WEBSTER AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1361
Practice Address - Country:US
Practice Address - Phone:845-483-5858
Practice Address - Fax:845-483-5776
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304609363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY304609OtherLICENSE