Provider Demographics
NPI:1497883383
Name:SANCHEZ, CATHERINE MARY (DTR)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARY
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SKIDMORE PL
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4336
Mailing Address - Country:US
Mailing Address - Phone:631-539-8741
Mailing Address - Fax:
Practice Address - Street 1:9 SKIDMORE PL
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4336
Practice Address - Country:US
Practice Address - Phone:631-539-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY835053136A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered