Provider Demographics
NPI:1093837007
Name:FEDELI, CATHARINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHARINE
Middle Name:
Last Name:FEDELI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CENTRAL PARK W
Mailing Address - Street 2:SUITE # 1 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3015
Mailing Address - Country:US
Mailing Address - Phone:212-580-8187
Mailing Address - Fax:212-875-1218
Practice Address - Street 1:275 CENTRAL PARK W
Practice Address - Street 2:SUITE # 1 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3015
Practice Address - Country:US
Practice Address - Phone:212-580-8187
Practice Address - Fax:212-875-1218
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171244-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY171244-1OtherMEDICAL LICENSE