Provider Demographics
NPI:1396187142
Name:MCCATTY, FLORIZEL BETHUNE
Entity type:Individual
Prefix:MRS
First Name:FLORIZEL
Middle Name:BETHUNE
Last Name:MCCATTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 CONWAY RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3519
Mailing Address - Country:US
Mailing Address - Phone:516-424-3661
Mailing Address - Fax:
Practice Address - Street 1:571 CONWAY RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3519
Practice Address - Country:US
Practice Address - Phone:516-424-3661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily