Basic Information
Provider Information
NPI: 1609042852
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRISON-RESTELLI
FirstName: CATHERINE
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6565 N CHARLES ST
Address2: SUITE PPE # 211
City: BALTIMORE
State: MD
PostalCode: 212046800
CountryCode: US
TelephoneNumber: 4438492368
FaxNumber: 4438492248
Practice Location
Address1: 6565 N CHARLES ST
Address2: SUITE PPE # 211
City: BALTIMORE
State: MD
PostalCode: 212046800
CountryCode: US
TelephoneNumber: 4438492368
FaxNumber: 4438492248
Other Information
ProviderEnumerationDate: 05/07/2008
LastUpdateDate: 10/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0015XD69084MDY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine

No ID Information.


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