Provider Demographics
NPI:1336270511
Name:PAINTER, CATHERINE JEAN (MD-PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JEAN
Last Name:PAINTER
Suffix:
Gender:F
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:142 AUDUBON AVENUE
Mailing Address - Street 2:(C/O INCARNATION CHILDREN'S CENTER)
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2199
Mailing Address - Country:US
Mailing Address - Phone:212-928-2590
Mailing Address - Fax:212-928-1500
Practice Address - Street 1:142 AUDUBON AVE
Practice Address - Street 2:INCARNATION CHILDREN'S CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2102
Practice Address - Country:US
Practice Address - Phone:212-928-2590
Practice Address - Fax:212-928-1500
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206807208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01750141Medicaid