Provider Demographics
NPI:1568413201
Name:FORRESTER, CATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:FORRESTER
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 1:64 GRAND CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAVALLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:08735-2010
Mailing Address - Country:US
Mailing Address - Phone:732-793-7125
Mailing Address - Fax:732-830-3421
Practice Address - Street 1:64 GRAND CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LAVALLETTE
Practice Address - State:NJ
Practice Address - Zip Code:08735-2010
Practice Address - Country:US
Practice Address - Phone:732-793-7125
Practice Address - Fax:732-830-3421
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA039547207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1090003Medicaid
NJ55695M9PMedicare ID - Type Unspecified
NJC61608Medicare UPIN