Provider Demographics
NPI:1396821757
Name:PREMORE, CATHERINE LAUNDRIE (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LAUNDRIE
Last Name:PREMORE
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:WENDY
Other - Last Name:LAUNDRIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS PT
Mailing Address - Street 1:39 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901
Mailing Address - Country:US
Mailing Address - Phone:518-563-0267
Mailing Address - Fax:518-563-1633
Practice Address - Street 1:39 COURT ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-563-0267
Practice Address - Fax:518-563-1633
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P21578Medicare UPIN
NYCC3820Medicare ID - Type Unspecified