Provider Demographics
NPI:1184656886
Name:MONDONEDO, CATHERINE REYES (NP-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:REYES
Last Name:MONDONEDO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5220
Mailing Address - Country:US
Mailing Address - Phone:212-337-9416
Mailing Address - Fax:
Practice Address - Street 1:607 HUDSON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1876
Practice Address - Country:US
Practice Address - Phone:212-337-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340455363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology