Provider Demographics
NPI:1073734661
Name:COMINS, CATHERINE A (PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:COMINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COVEY RD.
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538
Mailing Address - Country:US
Mailing Address - Phone:845-229-0848
Mailing Address - Fax:845-229-1115
Practice Address - Street 1:387 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603
Practice Address - Country:US
Practice Address - Phone:845-452-2102
Practice Address - Fax:845-229-1115
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008147-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004236OtherVALUE OPTIONS PROVIDER #
NY008147-1OtherSTATE LICENSE
NY680-3664OtherEMPIRE GHI PROVIDER NUMBE
NYV69471Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER