Provider Demographics
NPI:1891927596
Name:SCHROEDER, CATHERINE ALLEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ALLEN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 RIDGEWAY AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4296
Mailing Address - Country:US
Mailing Address - Phone:585-723-7060
Mailing Address - Fax:585-723-7325
Practice Address - Street 1:2655 RIDGEWAY AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-723-7060
Practice Address - Fax:585-723-7325
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430452-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03252288Medicaid
NYJ400050814/GP BA0017Medicare PIN
NY03252288Medicaid