Basic Information
| Provider Information | |||||||||
| NPI: | 1861593873 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIAZON-LEVISTE | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | LIM | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SIAZON | ||||||||
| OtherFirstName: | CATHERINE | ||||||||
| OtherMiddleName: | LIM | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 29 DAHLGREN PLACE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189214393 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1000 SILVER STREET | ||||||||
| Address2: | CONNECTICUT VALLEY HOSPITAL | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064577023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602625868 | ||||||||
| FaxNumber: | 8602625850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 09/18/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 180603 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.