Provider Demographics
NPI:1124371141
Name:CATHERINE SCRENCI MD PLLC
Entity Type:Organization
Organization Name:CATHERINE SCRENCI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRENCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-759-1234
Mailing Address - Street 1:3 SCHOOL ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2590
Mailing Address - Country:US
Mailing Address - Phone:516-759-1234
Mailing Address - Fax:516-674-9172
Practice Address - Street 1:3 SCHOOL ST
Practice Address - Street 2:SUITE 302
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2590
Practice Address - Country:US
Practice Address - Phone:516-759-1234
Practice Address - Fax:516-674-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty