Provider Demographics
NPI:1407260581
Name:CARR, CATINA A (RRA)
Entity Type:Individual
Prefix:
First Name:CATINA
Middle Name:A
Last Name:CARR
Suffix:
Gender:F
Credentials:RRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:MILLENNIUM MEDICAL IMAGING
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110
Mailing Address - Country:US
Mailing Address - Phone:518-268-5590
Mailing Address - Fax:
Practice Address - Street 1:1300 MASSACHUSETTES AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12080
Practice Address - Country:US
Practice Address - Phone:518-268-5590
Practice Address - Fax:518-268-5534
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR000204243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant