Provider Demographics
NPI:1497751168
Name:HOLMES, CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-832-8150
Mailing Address - Fax:860-224-6953
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-832-8150
Practice Address - Fax:860-224-6953
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001405118Medicaid
CT010040511CT01OtherBCBS N BCFP PROV ID
CT1255448155OtherGHMC GRP NPI ID
CTP2720404OtherOXFORD PROV ID
CT004215324Medicaid
CT7542369OtherAETNA REF ID
CTC01373OtherGHMC GRP MEDICARE ID
CT040511OtherCONNECTICARE PROV ID
CT2V2142OtherHEALTH NET PROV ID
CT1308844OtherCIGNA PROV ID
CT368438OtherWELLCARE MEDICARE
CT7542369OtherAETNA REF ID
CT110008680Medicare ID - Type Unspecified