Provider Demographics
NPI:1447218813
Name:LALA, CATHERINE (NPP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LALA
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 GREEN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3716
Mailing Address - Country:US
Mailing Address - Phone:845-339-3736
Mailing Address - Fax:845-339-6731
Practice Address - Street 1:105 MARY AVENUE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-338-2500
Practice Address - Fax:845-334-3172
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4005151363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
887739Medicare UPIN
NY91N831Medicare ID - Type Unspecified