Provider Demographics
NPI:1609991157
Name:DIFALCO, CATHERINE (OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:DIFALCO
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3757
Mailing Address - Country:US
Mailing Address - Phone:914-381-1159
Mailing Address - Fax:914-381-1932
Practice Address - Street 1:501 E BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3757
Practice Address - Country:US
Practice Address - Phone:914-381-1159
Practice Address - Fax:914-381-1932
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005775156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician