Active NPI
Catherine C DO, BS
- Pharmacist
- Ridgewood, NY
National Provider Identifier
1790966901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33653
- Practice address
- 6654 Fresh Pond Rd
Ridgewood, NY 11385-3245 - Phone
- (718) 821-2222
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 33653 | NY | Primary |
Addresses
Primary practice location
6654 Fresh Pond Rd
Ridgewood, NY 11385-3245
Mailing address
6654 Fresh Pond Rd
Ridgewood, NY 11385-3245
Phone (718) 821-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01580652 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33653 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1790966901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6654 FRESH POND RD",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853245",
"telephone_number": "718-821-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6654 FRESH POND RD",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853245",
"telephone_number": "718-821-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "CATHERINE",
"middle_name": "C",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "33653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01580652",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.