Provider Demographics
NPI:1689932725
Name:MOCKLER, CATHERINE BRIDGET (MS OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:BRIDGET
Last Name:MOCKLER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 OLTMANN RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3313
Mailing Address - Country:US
Mailing Address - Phone:516-987-4340
Mailing Address - Fax:
Practice Address - Street 1:535 E 119TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4433
Practice Address - Country:US
Practice Address - Phone:212-860-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014215172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker