Provider Demographics
NPI:1639149297
Name:QUAGLIETTA, CATHLEEN BELLE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:BELLE
Last Name:QUAGLIETTA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:600 WESTAGE BUSINESS CTR DR
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2281
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-231-5670
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360386363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400117124Medicare PIN
S87725Medicare UPIN
NY91N671Medicare PIN