Provider Demographics
NPI:1669452041
Name:CANTWELL, CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:CANTWELL
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 1:335 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1728
Mailing Address - Country:US
Mailing Address - Phone:585-393-2888
Mailing Address - Fax:585-396-9275
Practice Address - Street 1:335 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1728
Practice Address - Country:US
Practice Address - Phone:585-393-2888
Practice Address - Fax:585-396-9275
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193618207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010193618OtherBLUE CHOICE
NY01437356Medicaid
NY2718OtherBLUE SHIELD
NYMD168VOtherPREFERRED CARE
NY16025IMedicare ID - Type Unspecified