Provider Demographics
NPI:1346549391
Name:CATINDIG, IRENE DE SOTTO
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:DE SOTTO
Last Name:CATINDIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 HEATHER TRACE LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056
Mailing Address - Country:US
Mailing Address - Phone:704-675-5510
Mailing Address - Fax:
Practice Address - Street 1:520 E TRADE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:NC
Practice Address - Zip Code:28034-1755
Practice Address - Country:US
Practice Address - Phone:704-864-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist