Provider Demographics
NPI:1447574900
Name:CLELAND, CATHERINE DZIOK (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DZIOK
Last Name:CLELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MARY
Other - Last Name:DZIOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2105
Mailing Address - Fax:413-582-2059
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2105
Practice Address - Fax:413-582-2059
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA257888207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400312036Medicare UPIN