Provider Demographics
NPI:1083666200
Name:HANSEN, CATHERINE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:42 SPLIT ROCK LN
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-3438
Mailing Address - Country:US
Mailing Address - Phone:914-235-2559
Mailing Address - Fax:212-939-1841
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:914-772-8642
Practice Address - Fax:914-772-8642
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT499372080N0001X
NY1622882080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00906592Medicaid
NY00906592Medicaid
NYD91886Medicare UPIN