Basic Information
| Provider Information | |||||||||
| NPI: | 1396462032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARABUT | ||||||||
| FirstName: | CATHERINE | ||||||||
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| Credential: | PTA,PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21726 138TH RD | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114132608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4697931685 | ||||||||
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| Practice Location | |||||||||
| Address1: | 27111 76TH AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110401436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182892100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2022 | ||||||||
| LastUpdateDate: | 10/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1307528 | TX | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225200000X | 012116-01 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.