Basic Information
| Provider Information | |||||||||
| NPI: | 1902831068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERTINUSON | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RD LDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 925 | ||||||||
| Address2: | JEFFREY KORFF MD | ||||||||
| City: | WILBRAHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010950925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085950531 | ||||||||
| FaxNumber: | 5088295367 | ||||||||
| Practice Location | |||||||||
| Address1: | 264 ELM STREET | ||||||||
| Address2: | JEFFREY KORFF MD | ||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135850039 | ||||||||
| FaxNumber: | 4135862148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 133V00000X | 170 | MA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
ID Information
| ID | Type | State | Issuer | Description | LD0170 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | AA29800 | 01 | MA | HARVARD PILGRIM | OTHER |