Provider Demographics
NPI:1407610561
Name:SUTTON, CATHY LYNN
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:LYNN
Other - Last Name:POUPORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:355 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1827
Mailing Address - Country:US
Mailing Address - Phone:518-481-1728
Mailing Address - Fax:518-481-1582
Practice Address - Street 1:355 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1827
Practice Address - Country:US
Practice Address - Phone:518-481-1728
Practice Address - Fax:518-481-1582
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator