Provider Demographics
NPI:1932110152
Name:KATINAS, LORI CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:CATHERINE
Last Name:KATINAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:270-05 76 AVENUE
Mailing Address - Street 2:DEPARTMENT OF MEDICINE
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-3377
Mailing Address - Fax:718-962-6774
Practice Address - Street 1:1470 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-0863
Practice Address - Fax:212-831-8116
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229400207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02744461Medicaid