Basic Information
| Provider Information | |||||||||
| NPI: | 1952564403 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONCERT | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 456 STOCKHOLM ST | ||||||||
| Address2: | |||||||||
| City: | RIDGEWOOD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113851333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183862336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 UNION SQ E | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100033314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128448020 | ||||||||
| FaxNumber: | 2128446306 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2008 | ||||||||
| LastUpdateDate: | 07/04/2008 | ||||||||
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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 | 363LF0000X | 332119 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.