Provider Demographics
NPI:1396462032
Name:MARABUT, CATHERINE (PTA,PT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MARABUT
Suffix:
Gender:F
Credentials:PTA,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21726 138TH RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2608
Mailing Address - Country:US
Mailing Address - Phone:469-793-1685
Mailing Address - Fax:
Practice Address - Street 1:27111 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1436
Practice Address - Country:US
Practice Address - Phone:718-289-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012116-01225200000X
TX1307528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant